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  1.                ┌───────────────────────────────┐
  2.                       │ SM Money v1.0 -- ORDER FORM   │
  3.                        └───────────────────────────────┘
  4.               ┌Mailing Information───────────────────────────────┐
  5.               │                                                  │
  6.               │       (Your name will be displayed in the        │
  7.               │         product information dialog box.)         │
  8.               │                                                  │
  9.               │ PLEASE PRINT                                     │
  10.               │                                                  │
  11.               │    Name_________________________________________ │
  12.               │                                                  │
  13.               │ Company_________________________________________ │
  14.               │                                                  │
  15.               │ Address_________________________________________ │
  16.               │                                                  │
  17.           │    City__________________ State___ Zip__________ │
  18.               │                                                  │
  19.               │           Disk Size: ( ) 3.5" HD ( ) 5.25" HD    │
  20.               │                                                  │
  21.               │   Phone (    )____-______                        │
  22.               │                                                  │
  23.               └──────────────────────────────────────────────────┘
  24.    ┌Ordering Information────────────────────────────────────────────────────┐
  25.    │                                                                        │
  26.    │ Quantity                                          Price       Total    │
  27.    │ ______________________________________________________________________ │
  28.    │                                                                        │
  29.    │ ____ copies of SM Money v1.0 for OS/2 2.x         $20.00   _______.___ │
  30.    │                                                                        │
  31.    │            Illinois residents please add 6.25% sales tax   _______.___ │
  32.    │                                                                        │
  33.    │                                              Order Total*  _______.___ │
  34.    │                                                                        │
  35.    │ * Check or money order ONLY.  Sorry, no credit cards, purchase orders  │
  36.    │   or C.O.D.s.  Checks must be in US Dollars.  Please do not send cash. │
  37.    │                                                                        │
  38.    │                           Signature___________________________________ │
  39.    │                                                                        │
  40.    │ Where did you obtain SM Money?  ______________________________________ │
  41.    └────────────────────────────────────────────────────────────────────────┘
  42.                        ┌Important Information──────────┐
  43.                    │                               │
  44.                        │ All information disclosed on  │
  45.                        │ this form is kept strictly    │
  46.                        │ CONFIDENTIAL                  │
  47.                        │                               │
  48.                        │ Please make check or money    │
  49.                        │ order payable to:             │
  50.                │                               │
  51.                │    Scott Mosier               │
  52.                │                               │
  53.                │ Please send this order form   │
  54.                │ with check or money order to: │
  55.                │                               │
  56.                │    SM Soft                    │
  57.                │    Scott Mosier, President    │
  58.                │    1705 Lakewood Dr.          │
  59.                │    Mendota, IL  61342         │
  60.                └───────────────────────────────┘
  61.