
             Order to PsL for product #30121 (ClipFile)


1.  Information about you:


    First/Middle Name       ________________________________________

    Last Name               ________________________________________

    Company (if applicable) ________________________________________

    Address line 1          ________________________________________

    Address line 2          ________________________________________

    City                    ________________________________________

    State/Province/Region/County  __________________________________

    Zip/Post-code           _____________   Country ________________

    Phone # (voice)         ________________________________________

    Your email address      ________________________________________


2.  Information about your credit card (MC, Visa, Amex, Discover):

    Card number             ________________________________________

    Expiration (mm/yy)      ___/___

    If the card holder's name and address is DIFFERENT from the
	name and address in section 1, please include SECTION 4 below.


3.  Number of ClipFile licenses required:

    These are priced as follows

    1 - 4       $19 each
    5 - 9       $15 each
    10 or more  $10 each


    Please send me ______ licenses for ClipFile

    IMPORTANT!
    Please enter the lock code(s) below, one for each copy ordered

    _________________________________________________________________________

    _________________________________________________________________________

------------------- cut here if section 4 is not required -------------------


4.  Information about the credit card holder:

    The information in this section is ONLY needed if it is
    DIFFERENT from the name and address in section 1.

    Do NOT enter the BANK's name or address here!

    Name on the card        ________________________________________

    Company (if applicable) ________________________________________

    Address line 1          ________________________________________

    Address line 2          ________________________________________

    City                    ________________________________________

    State/Province/Region/County  __________________________________

    Zip/Post-code           _____________   Country ________________

------------------- cut here if section 4 is included -----------------------


5.  Send the completed sections of the form above to:

        Either email to     30121@pslweb.com

        Or FAX to           +1 (713) 524-6398

    Email is preferable.
    If you have email, please also email ASSoft@compuserve.com
    to let us know you have placed an order with PsL


            HAVE YOU COMPLETED ALL THE NECESSARY INFORMATION?
                    PLEASE CHECK THAT IT IS ACCURATE!

