Manifold book with a flexible cover contains carbonless receipt forms that are consecutively numbered in red. Security screen prevents alterations on the three-part forms. Paper sequence is originals in white, duplicates in yellow and triplicates in pink. Duplicates feature black print. Each form includes a place for date, payment amount, name of payer, payer's address, item description, and recipient name. A chart along the bottom breaks down the payment and includes boxes to fill in the amount of account, amount paid, balance due and payment method with preprinted boxes for cash, check and money order.