--------------------------- O R D E R F O R M ------------------------ Please send order form to: Software Store Products, Inc. 10351 SW 69th Court or fax to (352)237-0662 Ocala, FL 34476 (Credit Card orders only) U.S.A. Company: __________________________________________________________ Contact: __________________________________________________________ Address: __________________________________________________________ __________________________________________________________ __________________________________________________________ Phone: ___________________________ Please Check The Video Store 3.0 Upgrade ............................ $149.00 [ ] The Credit Card Store module * .......................... $39.95 [ ] Sales Tax (Florida State Residents add 6%) .............. ______________ Shipping ................................................ FREE Overseas Orders (Please add $5.00) ...................... ______________ Total Enclosed .......................................... ______________ -----------------------CREDIT CARD ORDERS ONLY-------------------------- Card Type: ___VISA ___MASTERCARD Card #__________________________________________ Expiry date __________ Name of cardholder______________________________________________________ Signature___________________________________________ Date _____________ ------------------------------------------------------------------------ Make Check or Money Order payable to: Software Store Products, Inc. (Please Note: Payment must be made in United States funds. Checks held for 2 weeks before processing.) * The Credit Card Store module requires a VeriFone Credit Card Terminal.