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| 正面描述 | Pink and black letterpress text set within a light-orange rectangular panel bordered in pink, with a central ornamental vignette. The denomination and issuing bank name are printed in black across the face, with the text of the cheque order in Italian. A serial number in black print appears at lower left. |
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| 背面描述 | Plain paper reverse with black text arranged in two distinct zones: a vertical legend enclosed in a rectangular panel at left reading the circulation restriction clause and endorsement heading, and to the right a rubber-stamped endorsement by Nummus - Kalos of Montecopiolo with a handwritten signature below. |
| 背面铭文 | IL PRESENTE ASSEGNO PUO` CIRCOLARE SOLTANTO IN ITALIA GIRATE NUMMUS - KALOS Montecopiolo (Pesaro) Tel. (0722) 78125 |
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