Ellipsis Order Form

FAX ORDER FORM
Print, Complete & Fax this Form to Place Your Order

PHONE	312-782-5290	ONLINE	http://www.ellipsissoftware.com
FAX	312-782-5194	MAIL	309 W. Washington, Suite 800 Chicago, IL 60606

ORDERED BY	SHIP TO
Name	Name
Company	Company
Address	Address
City/State/Zip	City/State/Zip
Day Telephone	Day Telephone
Fax	Fax
E-Mail Address	E-Mail Address

METHOD OF PAYMENT

1. Credit Card (circle one) VISA * MasterCard * American Express

Card Number: ______________________________________________________ Expiration (m/y): _____/_____

Name on Card: _____________________________________________________

Signature: _________________________________________________________

2. Check Please make check payable to Realogic Software, Inc.

3. Purchase Order Number Please attach copy of P.O.

Qty	Product	Unit Price	Ext. Price






		Sales Tax
		Sub-Total

SHIPPING	RETURN POLICY	WARRANTY
Shipping charges vary based on weight, type of service and destination.	All software products are guaranteed to perform to your satisfaction for 30 days. You can return the software for a full refund for any reason within 30 days from the date of purchase.	Customers receive free support and maintenance releases for the version of the product you purchased for a period of 1 year from the date of purchase. Please see pricing information for support options after 1 year.