Order and Invoice
Syncom, Inc.
P.O. Box 1592
Morristown, New Jersey  07960-1592


Ship to:
Name:           _______________________________________________________
Company         _______________________________________________________
Department      _______________________________________________________
Address:        _______________________________________________________
City, State Zip _______________________________________________________
Phone:          _____________________________


Please Enter the following order:

Quantity 
Ordered    Description                                 Price Ea.        Ext

_______    Cleanup! Custom Control for Visual Basic     $12.00*   $________.__
                      New Jersey & New York residents 
                            add applicable sales tax.             $________.__

                                  Shipping & Handling                    $3.00

                                                 Total:           $___________

* International Orders add $3.00
Please make checks and money orders Payable to: Syncom, Inc.


Credit Card Information:

/__/ AmEx     /__/ Visa    /__/ MasterCard
Credit Card Number:     _________________________________________
Exp. Date:              ______ / _____
Signature:              _________________________________________


Mail this order to:
Syncom, Inc.
P.O. Box 1592
Morristown, New Jersey  07960-1592
or fax your order to 1-201-267-6605