---------------------------------------------------------------------------- ULTRAFIND ORDER FORM - USA AND CANADA LANDWARE, INC. *PLEASE PRINT CLEARLY* 2.5.3 ---------------------------------------------------------------------------- LandWare, Inc., P.O. Box 25, Oradell, NJ 07649 How to order: (1) By phone with any major credit card: (201) 261-7944 or (2) Fill out and fax this order form to: (201) 261-7949 or (3) Fill out and mail this order form to LandWare (address above) or (4) Fill out the special email form and email it to sales@landware.com or (5) Fill out the online order form at http://www.landware.com Date : ---------------------------------------------------------------------------- Name : Organization : Mailing Address : Country : Phone : E-mail : ---------------------------------------------------------------------------- Amount ---------------------------------------------------------------------------- UltraFind Single User License : ...x $39.95 $........... UltraFind 5-User License : ...x $139.00 $........... UltraFind 10-User License : ...x $195.00 $........... Tax (NJ residents only - 6%) : $........... TOTAL $___________ Method of payment: ___ Check/Money order (U.S. checks/funds only - payable to LandWare, Inc.) ___ VISA ___ MasterCard ___ American Express ___ Discover ___ First Virtual Card Number : Card Holder's Name : Exp. Date : ---------------------------------------------------------------------------- Thank you