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*   Registration for:   Fserv for Windows 95/98 Windows NT.          *
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Name:

Address:

City:

State/Province:

Zip Code:

Country:

Phone number:

***E-mail address:

I would like to order ___ copies of Fserv (v3.02  or later with log)  @ $10.00 U.S. each.


Payment enclosed (check one):
	
____ Check drawn on a US bank

____ Money order


Send this form filled out with payment
totalling US $10.00 dollars to our U.S.A. office :

        Donald Leavitt 
	AMAZON Systems
        17940 Gulf Blvd 
	Redington, Florida 33708



Thank You!
