Payroll Plus! by Daniel Burgin
CUSTOM TEMPLATE FORM

Please Print out, Fill out, and Send this form to:

Daniel Burgin
P.O. Box 122
Flourtown, PA 19031

Make checks payable to: Daniel Burgin

USER INFORMATION

NAME_________________________________________

ADDRESS_______________________________________

CITY___________________________________________

STATE_________________ZIP______________________

VOICE PHONE (___)__________FAX(___)______________



RATE SCHEDULE

Shareware Fee (use of template as is)...............................$10.00

Custom Template  (10 employees or less).......................$30.00

Custom Template  (10-20 employees)..............................$45.00

Custom Template  (20-30 employees).............................$100.00

Custom Template  (30 plus employees).........................quote (call BBS 215-247-7331
																																																																																																														and e-mail SysOp)
																																																																																																														or call 215-247-6403)
	FREE UPDATES for changing tax rates........................once no charge
( From time to time tax rates                                            thereafter $10.00 per update.
   increase, they NEVER decrease,
   in your district.)							
_____________________________________________________



How many employees do you want the template to figure?____________
  (Max. 10...for more, the fee is higher. See scale above.)

What is the highest GROSS pay that you will need to calculate at?_______

What is your Social Security Tax Percentage?_____________________

What is your State Tax Rate, if you have one?_____________________

What is your City Tax Rate, if you have one?______________________

What is your Unemployment Tax Rate, if you have one? _____________

Are there any other taxes or assessments that you would like Payroll Plus! to
calculate? If so include a list and their percentages, below.












Expect your custom template in 2-4 weeks, usually less.