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| Send Orders to:              | INVOICE/REG. NO.      |                       |
| EZX Publishing & Distributing|                       | YOUR P.O. OR OTHER NO |
| Box 58177                    |-----------------------+-----------------------|
| WEBSTER, TX 77598-8177  USA  |DATE:                  |REF/EXT:               |
|713/280-9900 FAX:713/280-0099 |-----------------------------------------------|
|-------------------------------Eff.10/93    U P S SHIPPER # T X  X X X- X X X |
|-------------------------------------------  Red Label? [  ]    ZONE [      ] |
| SOLD TO: (ATTN: ACCOUNTS PAYABLE)        |  Blue Label?[  ]                  |
|------------------------------------------|  Ground?    [  ]   WEIGHT[      ] |
|                                          |  Mail?      [  ]                  |
|                                          |  Insured?   [  ] $                |
|                                          |  Certified? [  ]  See rates below.|
|                                          |  Other?     [  ]  S&H is $7 min.  |
|                                          | ----------------------------------|
|                                          | |SPECIAL INSTRUCTIONS:            |
|------------------------------------------- |                                 |
|^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^# |You may order with your VISA,    |
|  S H I P  T O : (IF DIFFERENT THAN ABOVE)# |MasterCard, American Express, or |
|------------------------------------------# |Discover credit card by calling: |
|                                          # | 1-713-280-9900                  |
|                                          # | OrderFAX:1-713-280-0099         |
|                                          # |      For any other information  |
|                                          # |including p.o.s and site licen-  |
|                                          # |sing, etc. call: 1-713-280-9900  |
|                                          # |FAX This FORM for ORDERS or INFO |
|                                          # | TO FAX: 1-713-280-0099 (24hrs)  |
|..........................................#-----------------------------------|
|TERMS: PAYMENT DUE ON DELIVERY. OTHER?                      SOLD BY:          |
|------------------------------------------------------------------------------|
|TAX EXEMPT?        REASON:          TAX #                   EXT:              |
|------------------------------------------------------------------------------|
|CONTACT:                           DATE:             TEL# (     )             |
|------------------------------------------------------------------------------|
|V/MC/AX/D #                              EXP. DATE:   /    AUTH CODE.         |
|(SPECIFY) Cardholder Name:                                               PROC?|
|TEL #S REQD: DAY/OFC    -          FAX    -         HM    -               ----|
|------------------------------------------------------------------------------|
|SOURCE OF ORDER?                    |Signature Required!                      |
|==============================================================================|
|   ITEM  (All products include manual)     |Quantity| Price  |    EXTENSION   |
|----------------------------------------------------+--------+----------------|
|                                             |      |$       |                |
|---------------------------------------------+------+--------+----------------|
|                                             |      |$       |                |
|---------------------------------------------+------+--------+----------------|
|                                             |      |$       |                |
|---------------------------------------------+------+--------+----------------|
|                                             |      |        |                |
|---------------------------------------------+------+--------+----------------|
|                                             |      |        |                |
|---------------------------------------------+------+--------+----------------|
| Prices are subject to change without notice.| CALL |        |                |
|-------------------------------------------------------------+----------------|
|S&I:$7 min.|$12-2day/US48|CANADA/APO/FPO/HI/AK/PR,$12|Fgn.$24|                |
|-------------------------------------------------------------+================|
|Add $2 for each addl. item. POs accepted from govt|SUB-TOTAL |                |
|& rated companies. ($50 minimum) ----------------------------+================|
|USA Checks only. 10 days to clear|SalesTax 8.25% TX must add.|                |
|---------------------------------+---------------------------+----------------|
|Amt.Rcvd.     Ck#      Due       |Shipping & Insurance Above |                |
|-------------------------------------------------------------+----------------|
|1-orig/2-label/3-customer/4-packing    THANK YOU! |    TOTAL |                |
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