Banknote Authentication Checklist Form
Complete this checklist to verify and document the authenticity of banknotes during inspection.
Date of Inspection
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Inspector Name
*
Banknote Denomination
*
Please Select
$1
$5
$10
$20
$50
$100
Other
Banknote Serial Number
*
Inspection Environment
*
Please Select
Natural Light
Artificial Light
Ultraviolet Light
Mixed Lighting
Watermark Presence
*
Present and Correct
Missing or Incorrect
Security Thread Check
*
Present and Authentic
Missing or Suspicious
Ultraviolet Features
*
Correct UV Response
No or Incorrect UV Response
Microprinting & Texture
Microprinting Clear
Raised Print Texture
Other Security Features Verified
Counterfeit Indicators or Anomalies Observed
Final Verification Outcome
*
Authentic
Suspect/Counterfeit
Submit Checklist
Should be Empty: