--------------------------- 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 Invoice Store 4.0 software ...................... $129.00 [ ] The Credit Card Store module * ....................... $39.95 [ ] Sales Tax (Florida State Residents add 6%) ........ ______________ Shipping .............................................. $4.00 Overseas Orders (Add an additional $6.00) ......... ______________ 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 are held for 2 weeks before processing.) * The Credit Card Store module requires a VeriFone Credit Card Terminal. Reseller Discounts Available.