PEOPLEFINDER ORDER FORM

To purchase any PeopleFinder or Skiptrace CD-ROM product, please complete this order form, and return it to Pallorium, Inc. along with your check or money order. To pay by credit card, please attach a completed Credit Card authorization form to this PeopleFinder Order Form. There is no charge for shipping or handling.   FOR AN ADOBE ACROBAT (.pdf) FORMATTED VERSION OF THIS FORM PLEASE CLICK HERE. PURCHASER'S SHIPPING INFORMATION (ALL INFORMATION IS REQUIRED) :   NAME: ______________________________________________________________ COMPANY NAME: ____________________________________________________ STREET ADDRESS:___________________________________________________ CITY and STATE (PROVINCE):__________________________________________ ZIP CODE (POSTAL CODE):____________________________________________ DAYTIME TELEPHONE NUMBER:_______________________________________ ELECTRONIC MAIL ADDRESS:_________________________________________ LICENSE OR BADGE NUMBER: ________________________________________ BADGE OR LICENSE ISSUED BY (STATE OR AGENCY): ___________________ BADGE OR LICENSE EXPIRATION DATE: ________________________________   (IMPORTANT: WE WILL NOT SHIP TO A P.O.B. WE WILL NOT SHIP WITHOUT CONFIRMATION OF CURRENT LICENSED INVESTIGATOR OR LAW ENFORCEMENT STATUS.) I HAVE ENCLOSED PAYMENT FOR THE FOLLOWING ITEMS :   PEOPLEFINDER CALIFORNIA 2007 (DVD); QUANTITY: ______________ Price: ($499.00/set)  CALIFORNIA PUBLIC RECORD MASTER 2007 (DVD); QUANTITY: ______ Price: ($199.00/set*)   CALIFORNIA PEOPLEFINDER ARCHIVE (DVD); QUANTITY: ______ Price: ($399.00/set*)   I QUALIFY FOR THE FOLLOWING DISCOUNTS: (PLEASE MARK THE APPROPRIATE DISCOUNT(S), IF ANY.) (  ) I HAVE ORDERED BETWEEN THREE (3) AND FIVE (5) SETS AT THE SAME TIME AND HAVE DEDUCTED TEN PERCENT (10%) FROM THE COST OF MY ORDER. (  ) I HAVE ORDERED MORE THAN FIVE (5) SETS AT THE SAME TIME AND HAVE DEDUCTED TWENTY PERCENT (20%) FROM THE COST OF MY ORDER. (  ) I AM A CURRENT SUBSCRIBER TO PALLTECH AND MY ACCOUNT IS IN GOOD STANDING. I HAVE DEDUCTED $25.00 FROM MY ORDER (  ) I ALSO QUALIFY FOR THE FOLLOWING SPECIAL DISCOUNT(S) (MAXIMUM OF TWO):   1. ____________________________________________________________   2. ___________________________________________________________ .   MY ORDER AND PAYMENT SUMMARY: I HAVE ORDERED A TOTAL OF: ______________SETS OF PEOPLEFINDER AND/OR SKIPTRACE CD-ROM PRODUCTS. I UNDERSTAND THAT I AM PROVIDED WITH THREE (3) ACTIVATIONS FOR EACH PURCHASED SOFTWARE PRODUCT AND THAT THERE WILL BE A CHARGE FOR ADDITIONAL ACTIVATIONS.   PLEASE CHECK ONE: (  ) I AM ENCLOSING MY CHECK OR MONEY ORDER IN THE AMOUNT OF: $___________________. (  ) I AM PAYING BY CREDIT CARD AND HAVE ATTACHED A "CREDIT CARD AUTHORIZATION" FORM.   To purchase any PeopleFinder or Skiptrace CD-ROM product, please complete this order form, and return it to Pallorium, Inc. along with your check or money order. To pay by credit card, please attach a completed Credit Card authorization form to this PeopleFinder Order Form. There is no charge for shipping or handling.