| FOR: | FOR SOFTWARE USER: |
| ZARCOM Help tm | Company :____________________________ |
| Box 56119 | Address:______________________________ |
| Valley Centre R.P.O. | _____________________________________ |
| Langley, B.C., Canada | _____________________________________ |
| * | Telephone No.:_________________________ |
| * | eMail:________________________________ |
| Signed:_______________________________ | Signed:_______________________________ |
| Date:________________________________ | Date:_________________________________ |