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------------------- INSTANT MAILER ---------------------- Please support quality shareware by registering it. We thank you for your support. GSZ+DSZ PAID Registration form (Worldwide) Remit To: Omen Technology INC FAX: 503-621-3735 POB 4681 Portland OR 97208-4681 GSZ+DSZ Quantity Discount Schedule, (per purchase). Each: 1 $30.00 2-4 $26.00 5-49 $22.00 50-99 $19.00 100-199 $16.00 200-499 $13.00 500-999 $10.00 1000+ $ 7.00 Purchase orders for less than $150 must be prepaid. Federal TAX ID #: 930858776 Oregon TAX ID #: 536565 ____ GSZ+DSZ Registrations & 1 Disk (5.25 in) ______ $15.00 off if PAID DSZ SNP CARD is INCLUDED with order! (see GSZ.DOC) 3.5 inch disk instead of 5.25 inch ADD $ 5.00 ______ Shipping/Handling UNLESS check enclosed ADD $ 5.00 ______ (Overseas air mailed at no extra charge) Total ______ ----------- INSTANT SINGLE QUANTITY REGISTRATION (Circle one) ----------- $15.00 off for your PAID DSZ SNP card!!! (see GSZ.DOC) 5.25" check enclosed $30.00 3.50" check enclosed $35.00 5.25" VISA/Mastercard $35.00 3.50" VISA/Mastercard $40.00 Payment by: Check (U.S. bank or branch) enclosed ( ) Visa/Mastercard ( ) Use Address on envelope ( ) check ( ) or: Name ___________________________________________________________________ Address ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ..... Following needed for Credit Card only ..... Work Phone (____) __________________ Home Phone (____) ________________ Card # _____________________________________________ EXPIRES _____________ Name of Cardholder ________________________________________________________ Signature __________________________________________________________________ (Credit card orders may call voice: 503-621-3406) ------------------- INSTANT MAILER ---------------------- Fold at the page break below with the printing facing out. Then fold letter style, exposing the mailing address and hiding your information. If necessary, staple check to the mailer, then staple or tape sides/top. _________________________________ Place _________________________________ Stamp _________________________________ Here Omen Technology INC Post Office Box 4681 Portland OR 97208-4681 U.S.A. GSZ+DSZ Apr-27-92

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