Claim Form Envelopes Left Window Envelope Sets Item No. Product Description Outer Color / Inner Color Outer Size Inner Size Inside Tint Y=Yes N-No Window Size From Left From Bottom Weight/Box 250/Set ES1 Self-Seal Window / Rl-4618 #6.75 Regular / Ts100-I IV, WH, GY BL, CAN, GN, GY, IV, WH 65⁄8 ˝ x 41⁄2 ˝ 61⁄8 ˝ x 39⁄16 ˝ Y Y 4˝ x 11⁄16 ˝ 1⁄2 ˝ 2˝ 4.7 Lbs ES2 #10 Self-Seal Window / Rl-4619 #6.75 Regular / Ts100-I GY, IV, WH BL, CAN, GN, IV, WH,GY 91⁄2 ˝ x 41⁄8 ˝ 61⁄8 ˝ x 39⁄16 ˝ Y Y 41⁄2 ˝ x 11⁄8 ˝ 7⁄8 ˝ 1⁄2 ˝ 5.5 Lbs ES3 #10 Self-Seal Window / Rl-4619 #9 Regular / Ts-9 BL, GY, IV, WH BL, CAN, GN, GY, IV, PK, WH 91⁄2 ˝ x 41⁄8 ˝ 87⁄8 ˝ x 37⁄8 ˝ Y Y 41⁄2 ˝ x 11⁄8 ˝ 7⁄8 ˝ 1⁄2 ˝ 6.2 Lbs ES5 Self-Seal Window / Wwswe-Ls #6.75 Regular / Ts100-i WH BL, CAN, GN, IV, WH 61⁄2 ˝ x 41⁄2 ˝ 61⁄8 ˝ x 39⁄16 ˝ Y Y 4˝ x 11⁄4 ˝ 3⁄4 ˝ 1⁄4 ˝ 6 Lbs ES6 #10 Gum Window / Wce-8651-D #9 Regular / Ts-9 WH BL, CAN, GN, GY, IV, PK, WH 91⁄2 ˝ x 41⁄8 ˝ 87⁄8 ˝ x 37⁄8 ˝ N Y 41⁄2 ˝ x 11⁄8 ˝ 7⁄8 ˝ 1⁄2 ˝ 6.5 Lbs ES7 #10 Gum Window / Wce-8651-D #6.75 Regular / Ts100-i WH BL, CAN, GN, GY, IV, WH 91⁄2 ˝ x 41⁄8 ˝ 61⁄8 ˝ x 39⁄16 ˝ N Y 41⁄2 ˝ x 11⁄8 ˝ 7⁄8 ˝ 1⁄2 ˝ 5.7 Lbs ES8 #10 Window / Wce-8651-St #6.75 Regular / Ts100-i WH BL, CAN, GY, IV, WH 91⁄2 ˝ x 41⁄8 ˝ 61⁄8 ˝ x 39⁄16 ˝ Y Y 41⁄2 ˝ x 11⁄8 ˝ 7⁄8 ˝ 1⁄2 ˝ 6.4 Lbs ES9 #10 Window / Wce-8651-St #9 Regular / Ts-9 WH BL, CAN, GN, GY, IV, PK, WH 91⁄2 ˝ x 41⁄8 ˝ 87⁄8 ˝ x 37⁄8 ˝ Y Y 41⁄2 ˝ x 11⁄8 ˝ 7⁄8 ˝ 1⁄2 ˝ 5.4 Lbs TS100 Self-Seal Window / Ts-100-O #6.75 Regular / Ts100-i BL, GN, IV, WH BL, CAN, GN, GY, IV, WH 69⁄16 ˝ x 41⁄2 ˝ 61⁄8 ˝ x 39⁄16 ˝ Y Y 4˝ x 11⁄4 ˝ 11⁄4 ˝ 13⁄4 ˝ 4.5 Lbs Pre-Inserted Envelope Sets Continued on next page HEALTHCARE ENVELOPES 12 Claim Form Envelopes (24 Lb. White Wove) Item No. Product Description Plain/ Imprint Overall Size Inside Tint Y=Yes N-No Window Size From Left From Bottom Weight/Box 500/Box WADA2002ENVSSI ADA 2002 Self-Seal Envelope Imprint 41⁄8 ˝ x 83⁄4 ˝ Y 4˝ x 11⁄8 ˝ 1⁄2 ˝ 3⁄4 ˝ 6 Lbs WADA2002ENVSSPL ADA 2002 Self-Seal Envelope Plain 41⁄8 ˝ x 83⁄4 ˝ Y 4˝ x 11⁄8 ˝ 1⁄2 ˝ 3⁄4 ˝ 6 Lbs WCMENVPL ADA06-UB04 Gum Window Envelope Plain 87⁄8 ˝ x 41⁄8 ˝ Y 41⁄8 ˝ x 7⁄8 ˝ 1⁄4 ˝ 3⁄4 ˝ 6 Lbs WCMENVI ADA06-UB04 Gum Window Envelope Imprint 87⁄8 ˝ x 41⁄8 ˝ Y 41⁄8 ˝ x 7⁄8 ˝ 1⁄4 ˝ 3⁄4 ˝ 6 Lbs WCMENVSSPL ADA06-UB04 Self-Seal Envelope Plain 87⁄8 ˝ x 41⁄8 ˝ Y 41⁄8 ˝ x 7⁄8 ˝ 1⁄4 ˝ 3⁄4 ˝ 6 Lbs WCMENVSSI ADA06-UB04 Self-Seal Envelope Imprint 87⁄8 ˝ x 41⁄8 ˝ Y 41⁄8 ˝ x 7⁄8 ˝ 1⁄4 ˝ 3⁄4 ˝ 6 Lbs WHCF10ENV Gum Window Envelope Imprint 91⁄2 ˝ x 41⁄8 ˝ Y 41⁄2 ˝ x 11⁄8 ˝ 4˝ 15⁄8 ˝ 6 Lbs WHCF10ENVPL Gum Window Envelope Plain 91⁄2 ˝ x 41⁄8 ˝ Y 41⁄2 ˝ x 11⁄8 ˝ 4˝ 15⁄8 ˝ 6 Lbs WHCF10ENVWL Self-Seal Window Envelope Imprint 91⁄2 ˝ x 41⁄8 ˝ Y 41⁄2 ˝ x 11⁄8 ˝ 1˝ 15⁄8 ˝ 6 Lbs WHCF10ENVWLPL Self-Seal Window Envelope Plain 91⁄2 ˝ x 41⁄8 ˝ Y 41⁄2 ˝ x 11⁄8 ˝ 1˝ 15⁄8 ˝ 6 Lbs WHCF10ENVSS Self-Seal Window Envelope Imprint 91⁄2 ˝ x 41⁄8 ˝ Y 41⁄2 ˝ x 11⁄8 ˝ 4˝ 15⁄8 ˝ 6 Lbs WHCF10ENVSSPL Self-Seal Window Envelope Plain 91⁄2 ˝ x 41⁄8 ˝ Y 41⁄2 ˝ x 11⁄8 ˝ 4˝ 15⁄8 ˝ 6 Lbs WHCF15ENVSSI Self-Seal Window Envelope Imprint 91⁄4 ˝ x 41⁄2 ˝ Y 5˝ x 11⁄4 ˝ 37⁄16 ˝ 2˝ 6 Lbs WHCF15ENVSSPL Self-Seal Window Envelope Plain 91⁄4 ˝ x 41⁄2 ˝ Y 5˝ x 11⁄4 ˝ 37⁄16 ˝ 2˝ 6 Lbs WHCF1500ENVSSI Self-Seal Window Envelope Imprint 9˝ x 121⁄2 ˝ Y 41⁄2 ˝ x 11⁄8 ˝ 4˝ 915⁄16 ˝ 20 Lbs WHCF1500ENVSSPL Self-Seal Window Envelope Plain 9˝ x 121⁄2 ˝ Y 41⁄2 ˝ x 11⁄8 ˝ 4˝ 915⁄16 ˝ 20 Lbs WHCF1500ENVSSBL Self-Seal Window Envelope Plain 9˝ x 121⁄2 ˝ Y 41⁄2 ˝ x 11⁄8 ˝ 4˝ 915⁄16 ˝ 20 Lbs WHCF1500ENVWLBL Self-Seal Window Envelope Plain 9˝ x 121⁄2 ˝ Y 41⁄2 ˝ x 11⁄8 ˝ 4˝ 915⁄16 ˝ 20 Lbs WHCF1500ENVWL Self-Seal Window Envelope Plain 9˝ x 121⁄2 ˝ Y 41⁄2 ˝ x 11⁄8 ˝ 11⁄4 ˝ 915⁄16 ˝ 20 Lbs WHCF1500ENVWLI Self-Seal Window Envelope Imprint 9˝ x 121⁄2 ˝ Y 41⁄2 ˝ x 11⁄8 ˝ 11⁄4 ˝ 915⁄16 ˝ 20 Lbs WUBENVSS Self-Seal Window Envelope Plain 57⁄8 ˝ x 9˝ Y 41⁄8 ˝ x 7⁄8 ˝ 1⁄4 ˝ 211⁄16 ˝ 6 Lbs WUBENVSSI Self-Seal Window Envelope Imprint 57⁄8 ˝ x 9˝ Y 41⁄8 ˝ x 7⁄8 ˝ 1⁄4 ˝ 211⁄16 ˝ 6 Lbs wubenvi Gum Envelope Imprint 57⁄8 ˝ x 9˝ Y 41⁄8 ˝ x 7⁄8 ˝ 1⁄4 ˝ 211⁄16 ˝ 6 Lbs WUBENVPL Gum Envelope Plain 57⁄8 ˝ x 9˝ Y 41⁄8 ˝ x 7⁄8 ˝ 1⁄4 ˝ 211⁄16 ˝ 6 Lbs
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