TO:  REFCO (SCOTLAND)
     BOX 14461
     GLENROTHES,FIFE
     SCOTLAND, UK                         E-MAIL: SCOREFCO@AOL.COM
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                  ORDER FORM for LWHIZ v1.31 Source Code Package
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 I/We wish to order the FULL source code package for LWHIZ. I enclose FULL
 payment for the equivalent of 45 Pounds Sterling. UK ONLY- Please ADD VAT

 I/We have read and I/We agree to acceptance of the conditions stipulated
 within Note 19 of the LWHIZ v1.31 README.TXT document.

    FROM:                          TODAYS DATE: ________________

    NAME:_______________________________________________________

    COMPANY:____________________________________________________

    ADDRESS: ___________________________________________________

             ___________________________________________________

             ___________________________________________________

    POST/ZIP CODE: ________________  COUNTRY: ___________________

    E-MAIL: _______________________  FAX: _______________________

    PHONE (DAY): __________________  PHONE (EVENING): __________________

 METHOD OF PAYMENT (To Be Enclosed): _____________________________________

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******* PAYMENT NOTES

 UK Customers use Cheque, Postal Order or Bankers Draft

 NON-UK Customers can use one of the following schemes:

 A BANKERS DRAFT drawn on a UK bank (apply to your own bank for this)
                                OR
                            EUROCHEQUE
                                OR
                           EURO TRANSFER

 Money transfers etc to OUR BANK at:  THE BANK OF SCOTLAND
                                      9 FALKLAND GATE
                                      GLENROTHES
                                      FIFE  KY7 5LW
                                      SCOTLAND, UK

   BANK SORT CODE: 80-08-09       OUR ACCOUNT NUMBER: 00342209
                                  OUR ACCOUNT NAME:   REFCO (SCOTLAND)
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 We can process your order most efficiently, if you e-mail us first
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