INVOICE/REGISTRATION FORM AC12TO10 - VERSION 2.22 For mail orders, please include this form. If possible, please use a text editor to enter the following information in overstrike mode and print with your printer. a) Total number of copies = ___ b) Enter number of copies (2 OR LESS) ___ x $49.95 = _____ c) Enter number of copies (MORE THAN 2) ___ x $19.95 = _____ d) Subtotal = _____ e) KY residents add 6% of Subtotal for KY sales tax = _____ f) Enter S/H = $3.00 g) Total Due = _____ Please make your check/money order payable to: Blue Ridge Software, Inc. Non-US customers may pay by cash or certified bank draft in U.S. dollars. Mail to: Blue Ridge Software, Inc. 235 Southport Drive Lexington, KY 40503 Credit Card Customers: ---------------------- VISA / Mastercard / AMEX (circle one) Enter you card number: ____________________________________ Expiration date: ________ Signature: _____________________________________ (Must be signed) Shipping Address: ----------------- Your name:_____________________________________________ Company name:__________________________________________ Address:_______________________________________________ City/State/Zip:________________________________________ Your order will be shipped within a few days of the receipt of this form. Special shipping conditions can be arranged if an order is placed by phone. Please include the customer comment form with your order - your comments are very important to us. (print section 11 of this file or the AC12TO10.CMT file) THANKS FOR YOUR ORDER!