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|     Register: FaxMail for Windows, FAX-V152.ZIP, 1-713-261-0307      |
| ElectraSoft, 3207 Carmel Valley Drive, MISSOURI CITY, TX  77459-3068 |
|== Please Print ======================================================|
|                                                                      |
| Date:____/____/____ Country:____________ Wk Phone:__________________ |
|                                                                      |
| Name:___________________________________ Hm Phone:__________________ |
|                                                                      |
| Address:________________________________ Fx Phone:__________________ |
|                                                             _        |
| City:______________________________ State:____ ZIP:_________________ |
|======================================================================|
| Disk size: __3.5-1.4MB  __5.25-1.2MB  __Other:______________________ |
|-----+----------------------------------------------------------------|
| Qty | Item                                                 Amount    |
|-----+----------------------------------------------------------------|
|     |                                                                |
|_____| FaxMail for Windows - - - - - - - - - - - - - $25.00 $_____.__ |
|     |                                                                |
|_____| OCR - - - - - - - - - - - - - - - - - - - - - $20.00 $_____.__ |
|     |                                                                |
|_____| Edit Fax  - - - - - - - - - - - - - - - - - - $10.00 $_____.__ |
|     |                                                                |
|_____| DCX to PCX Breakup  - - - - - - - - - - - - - $10.00 $_____.__ |
|     |----------------------- or --------------------------           |
|_____| All of the above ($10.00 savings) - - - - - - $55.00 $_____.__ |
|                                                                      |
| Shipping and handling - - - - - - - - - - - - - - -  $4.00 $____4.00 |
|                                                                      |
| Subtotal  - - - - - - - - - - - - - - - - - - - - - - - -  $_____.__ |
|                                                                      |
| Texas residents please add Sales Tax (8%) - - - - - - - -  $_____.__ |
|                                                                      |
| Total (Pay this amount) - - - - - - - - - - - - - - - -  US$_____.__ |
|======================================================================|
| Which Fax/Modem-Driver works best (found in your AUTOEXEC.BAT):      |
| __FM_ROCK2.COM  __FM_ROCK1.COM  __FM_ATT1I.COM  __FM_ATT2I.COM       |
| __FM_PP1.COM    __FM_CLS2I.COM  __FM_CLS2E.COM  __FM_DOVE1.COM       |
| __FM_DALAS.COM  __FM_ZOOM2.COM  __FM_ZYXEL.COM  __FM_CLAS1.COM       |
| __CAS(none) Fax/Modem Brand/Mod#:___________________________________ |
| Data Speed: __1200bps __2400bps __9600bps __14400bps __Other:_______ |
| FAX Speed:  __1200bps __2400bps __9600bps __14400bps __Other:_______ |
| Supported: __HST __V.32 __V.32bis __V.42bis __Other:________________ |
| Computer Brand:_____________________________________________________ |
| Processor: __8088 __80286 __80386 __80486 __Other:__________________ |
| Machine Speed: __25Mhz __33Mhz __50Mhz __66Mhz __Other:_____________ |
| Display Type: __CGA __EGA __VGA __SVGA __Other:_____________________ |
| Floppy Drive(s): __3.5, 1.4MB __5.25 1.2MB __Other:_________________ |
| HardDrive Brand/Mod#:_____________________________ size:__________MB |
| Bugs or suggested improvements (print on back):_____________________ |
| ____________________________________________________________________ |
| Signature:________________________________________ Date:____________ |
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