SMARTSHIELD worksheet and order form. Contactless smartcard, electronic commerce

SMARTSHIELD
WORKSHEET and ORDER FORM

We are currently reviewing the various forms of secure commerce over the Internet. At this point in time, we suggest you print out this worksheet and FAX it to us, call us directly or mail the completed order form in with your check or money order. Please feel free to e-mail us with any questions you may have. The preferred method of payment for sales outside of the United States is by credit card. VISA/Mastercard automatically provides their cardholders with an equitable currency exchange rate.

	Multiply the number of SMARTSHIELDs you wish to purchase by $29.99 to calculate your Subtotal. (Subtotal = number x $29.99):	Subtotal
	If you are an Illinois resident, please add 6.75% sales tax. (Tax = Subtotal x .0675):	Tax
	Citizens of the USA, Mexico or Canada, please add $2.00 for shipping and handling. All others please add $3.00.	S&H
	Calculate your Total by adding the previous 3 boxes together. (Total = Subtotal + Tax + Shipping):	Total

e-mail us FAX US at: (630) 587-6922 CALL US at: (630) 513-6835 MAIL Us at: Cord Technologies, Inc. P.O. Box 437 Wayne, Illinois 60184-0437	Name:
	Street Address:
	City:
	State/Province:
	Zip/Postal Code:
	Country:
	Phone Number:
	Fax Number:
	Email Address:
	Check One: VISA Mastercard Check
	Account Number:
	Signature:

Send your completed worksheet and order form along with
your signed check for the correct amount or credit card information to:
Cord Technologies, Inc.
P.O. Box 437
Wayne, Illinois 60184-0437