ANS X9.100-140- 2004

42 ©ASC X9, Inc. 2004- all rights reserved

Figure 11 – Original IRD Used for Qualified Return of a Business-Sized Check, Back 053000183 0

1/03/2002

1800539446

*011500120* 0

1/04/2002

8587408979

John Q. Customer

>031000011< 0

1/02/2002

7815830233

Subsequent endorsements overlay printed on Original IRD for Return.

(Centered in 1B.)

Initial BOFD endorsement printed on Original IRD for Return.

(Anchored at Bottom of 1B.)

Line and text overlay printed on Original IRD for Return.

Scaled Original Scanned Full Back Image

Do not endorse or write below this line.

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Back of Optional Qualified MICR

Perforation

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