Whats required to withdraw money from an account; the account number, routing, and some form of signature (I'm assuming ACH drops the signature requirement).

The USA is far behind on banking security. We're still using PIN numbers for debit cards and you could take my credit card and sign for any charges on it. A lot of people in the USA sign "CHECK ID" in the signature panel of their credit cards in an attempt to stop this. The idea is that if it says CHECK ID the clerk will definitely stop and check ID. But if it's not signed (which they aren's supposed to accept) or the signature is incorrect.. a store clerk will 99% of the time just pass it on. I actually never sign my credit cards because it requires a damned marker that won't look like my signature anyway.

I've never once been hassled.

> Why is the USA one of the only first-world countries that have such prevalent usage of cheques

I'm actually thinking about writing a blog post explaining my theory behind why this is the case. Would that be interesting?

tl;dr of my theory: geographic size and decentralized gov't in the US allowed a paper cheque system to outlive other countries'

Also probably the reason slavery lasted so much longer past the end of the civil war in parts of the South. Interesting parallel I guess, as paper checks seem just about as antebellum to me now.