- "Line 1 (on both)" is a required field.
- "Line 2 (on both)" is a required field.
- "Line 1 on reverse (on both)" is a required field.
- "Line 2 on reverse (on both)" is a required field.
- "Line 3 on reverse (on both)" is a required field.
- "Line 4 on reverse (on both)" is a required field.
- "Message Line 1 Below Money Slot" is a required field.
- "Message Line 2 Below Money Slot" is a required field.
- "Message Line 3 Below Money Slot" is a required field.