Order Form for Entisoft Tools

Please print this form, fill it out completely and fax to (310) 440-5562 or mail to:

Entisoft Company, Atten: Sales Department, 149 S. Barrington Ave., Suite 722 Los Angeles, CA 90049 or

Call toll free in the US (800) 610-0440, +1-310-472-3736

Today's date: ______________

Name: _____________________________ Phone #: _______________________

Company: _____________________________ FAX #: _______________________

Address: _____________________________ E-Mail Address:______________________

City: _____________________________

State/Province: _____________________________ ZIP/Postal Code: __________

Country: _____________________________

INDIVIDUAL USE

Entisoft Tools 2.0 Standard Edition

Individual use license at $179.95 each. # computers ____ x $179.95 = ______

Entisoft Tools 2.0 Professional Edition (Source Code & Entisoft SourceLink Technology™ included)

Individual use license at $399.95 each. # computers ____ x $399.95 = ______

MULTIPLE USE

Entisoft Tools 2.0 Standard Edition Pricing:

02 to 09 computers at (-20%) $161.20 each. # computers ____ x $161.20 = ______

10 to 24 computers at (-40%) $107.85 each. # computers ____ x $107.85 = ______

25 to 49 computers at (-50%) $89.98 each. # computers ____ x $ 89.98 = ______

50 to 99 computers at (-65%) $62.98 each. # computers ____ x $ 62.98 = ______

100+ computers at (-75%) $44.99 each. # computers ____ x $ 44.99 = ______

Entisoft Tools 2.0 Professional Edition Pricing:

02 to 09 computers at (-25%) $299.96 each. # computers ____ x $299.96 = ______

10 to 24 computers at (-49%) $239.97 each. # computers ____ x $239.97 = ______

25 to 50 computers at (-50%) $199.98 each # computers ____ x $198.98 = ______

50 to 100 computers at (-65%) $139.98 each # computers ____ x $138.98 = ______

100+ computers at (-75%) $ 99.99 each # computers ____ x $ 99.99 = ______

Subtotal: $________

California Residents add 8.25% sales tax: $________

Shipping & Handling:

Domestic US & Canada ($7) $_________

Outside US & Canada $25.00/item $________

TOTAL ENCLOSED US FUNDS $________ US$

CREDIT CARD PURCHASES: VISA ____ or MasterCard ____ or American Express ____

Card Number: _________-_________-_________-_________ Expiration Date: ______/______

Card Holder's Signature REQUIRED: _______________________________________

TERMS: VISA, MasterCard, American Express, Check or Money Order drawn on a U.S.A. bank in U.S.A. funds. Corporate Purchase orders (Net 30 days) accepted for software from large corporations within the USA & Canada. ALL LICENSES ARE PREPAID ONLY. ALL ORDERS OUTSIDE OF THE UNITED STATES AND CANADA MUST BE PREPAID. Please make remittance payable to ENTISOFT, Prices and terms subject to change without notice.