___Just send me a free sample of forms and reports.

Method of Payment:

CHECK __ CASHIRE CHECK__ MONEY ORDER__ VISA__ MC__ A/ X __ DISCOVER __

PLEASE MAIL THE SOFTWARE TO:

CUSTOMER NAME:__________________________________

ADDRESS:__________________________________________

CITY STATE ZIP:_____________________________________PHONE NUMBER: (___)________________

EMAIL ADDRESS :_________________________________________

NO. OF PROPETIES : ________ OWNER___ MANAGER___

I AUTHORIZE EMERALD TO CHARGE MY CARD FOR THE AMOUNT SHOWN ABOVE.

CARD NUMBER : _______________________________ EXP. DATE:___/___/___

SIGNATURE: X _______________________________ ALLOW 7 -10 DAYS FOR DELIVERY.