*** A_Line of Credit ORDER FORM *** TO: Planned Estates Corporation Pty Ltd 6 Maldon Crescent EAST DONCASTER VIC 3109 Phone and Fax (03) 9842 4980 FROM: Company:___________________________________________________________ Address:___________________________________________________________ State:__________ Postcode:_________ Contact Name:___________________________________________ Phone: (____)__________________ Fax: (____)__________________ Quantity Description Amount -------------------------------------------------------------------------- ________ Copy(s)of A_Line of Credit(Personal Use)@ $49.00 ea. $ ______ including YOU CALL US telephone support. ****************************************************** Media Type: (High Density Only) 5.25" [ ] 3.5" [ ] ****************************************************** ________ Copy(s)of A_Line of Credit(Multi Adviser)@ $599.00 ea. $ ______ including YOU CALL US telephone support. ****************************************************** Media Type: (High Density Only) 5.25" [ ] 3.5" [ ] ****************************************************** ________ Copy(s)of A_Line of Credit(Single Adviser)@ $299.00 ea. $ ______ including YOU CALL US telephone support. ****************************************************** Media Type: High Density [ ] 5.25" [ ] 3.5" [ ] ****************************************************** ________ Additional COMPANY NAME(S) @ $ 30.00 ea. $ ______ ====== TOTAL $ ====== REGISTERED COMPANY/ADVISER NAME(S) (Company Name and Adviser Name are printed on all Reports) (1) COMPANY __________________________________________ (Maximum of 50 characters) ADVISER ________________________________ (Maximum of 25 characters) (2) COMPANY __________________________________________ ADVISER ________________________________ (3) COMPANY __________________________________________ ADVISER ________________________________