========================================================================= The Brainex System 9124 Beverly Bl. Beverly Hills, CA 90210 310-275-2344 (HST) / 310-273-5234 (V.32bis) ------------------------------------------------------------------------- Invoice # : @INVOICE Date : @DATE Time : @TIME ------------------------------------------------------------------------- Card Holder: @CARDHOLDER User Name : @USERNAME Card Number: @CARDINFO Address : @ADDRESS Home Phone : @HOMEPHONE BBS Name : @BBSNAME BBS Phone : @BBSPHONE ------------------------------------------------------------------------- Item Description Price Shipping Amount ------------------------------------------------------------------------- @ITEM ------------------------------------------------------------------------- Sales Tax @TAX Shipping @SHIP Discount @DISC Total Charge $@TOTAL =========================================================================