Full Name:
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Contact person:
                 ---------------------------------
Street:
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Zip, City:
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Country:
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E-Mail or Fax: 
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    Star-Tools GmbH                    +----------------------+
    - Sales -                          ! Fax: +49 40 52950607 !
    Hopfenweg 207                      +----------------------+
    22851 Norderstedt
    Deutschland


O R D E R :

    Licence(s) DriveStar            each US$ 20.00  US$     .00
---  (Please fill in the number of systems)

( ) Registration Key, Invoice via E-Mail US$  0.00  US$     .00
( ) Registration Key, Invoice via Fax    US$  5.00  US$     .00
( ) Disk, Invoice via postal mail        US$ 10.00  US$     .00
                                                    -----------
      Total                                         US$     .00
                                                    ===========
Payment Options:

( ) Cash (not a draft) in advance
                                   ----------------------------
( ) VISA                            Card owner

( ) Euro-/MasterCard
                                   ----------------------------
( ) American Express                Card number

( ) After receiving Invoice
    (only to companies, min.       ----------------------------
     of US$ 100.00, shipping        Expire date
     only via postal mail)


                     ----------    ----------------------------
                      Date          Signature (Card owner)