| Product Name | 1-part UB-04 Laser-cut Forms |
| Packaged Quantity | 2500 / Carton |
| Manufacturer Part Number | 59870R |
| Form Width | 8.50" |
| Product Type | Claim Form |
| Printed Side | Front |
| Manufacturer Website Address | http://www.tops-products.com |
| Recycled | No |
| Print Color | Red |
| Brand Name | TOPS |
| Manufacturer | TOPS Products |
| Product Model | UB-04 |
| Country of Origin | United States |
| Product Color | White |
| Number of Parts | 1 |
| Form Length | 11" |