SpaceMan 99 Order Form
----------------------

Use this order form to order SpaceMan 99 by fax, email or mail.

Fax to:   713-524-6398
Email to: 30822@pslweb.com
Mail to:  PSL, P.O.Box 35705, Houston, TX 77235-5705

To order online, go to www.extrabit.com, and select "Order Online".

If you are not ordering by credit card, leave out the credit
card details section, and make checks payable to "PsL".
Checks must be in US$ and drawn on a US bank.

Leave out any details that do not apply (such as Company Name).


-----------------------------CUT HERE---------------------------
----------------------------------------------------------------

Purchase order for SpaceMan 99, product code 30822

----------------------------------------------------------------
Ship-To Name & Address:

Name.....................

Company Name.............

Address 1................
Address 2................
City.....................
State/Province...........
Zip......................
Country..................

Phone # (voice)..........

email address............

----------------------------------------------------------------
Credit Card Details

Credit card number.......
Expiration month/year....
Banks name and phone #...
(Cards accepted: MC, Visa, Amex, Discover.
 The BANK's name and phone number will be on the back of the card,
 or on your statement.  For AMEX, just enter 'AMEX'.
 All others MUST have bank's name & phone number.)

Credit Card Holder's Name & Address
(Only required if different to the name and address above).

Name on card.............
Company name.............
Address 1................
Address 2................
City.....................
State/Province...........
Zip......................
Country..................
(NOTICE: Address verification is done on every charge.
 If the credit card billing name & address do not match
 the address above, THE ORDER WILL NOT BE PROCESSED.
 The best place to get the billing address is from the
 monthly statement.)

----------------------------------------------------------------
Quantity

Number of licenses.......
Total cost...............
(1 license costs $15,
 2 to 9 licenses cost $5, plus $10 per license
 10 or more licenses cost $50, plus $5 per license)

Texas residents only:
Add 15% sales tax........


Total order value........

----------------------------------------------------------------