Manifold book with a flexible cover contains carbonless receipt forms that are consecutively numbered in red. Duplicates feature black print. Security screen prevents alterations on the two-part forms with originals in white and duplicates in yellow. Each page includes four forms. 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.