ProMilesOnline.com and Taxrate.com Order Form

Contact Name: ___________________________________ Position: ___________________________

Company Name: ____________________________________________________________________

Mailing Address:_____________________________________________________________________

City/Town: _______________________ Suite: _____ State/Prov: ________ Postal Code:__________

Phone: (______) ______-__________ Ext: _______ Fax: (______) ______-___________

Email Address: ________________________@____________________________________________

Do You or Your Company have a Web site? _____ If so, what is it http://www.______________._____

How did you here about us?____________________________________________________________

 

Subscription Type: please check the subscription type you are signing up for.

( ) ProMilesOnline.com Basic Subscription Cost

Monthly subscription single user (30 days) $39.00 U.S. ($59.00 Canadian) times # _____ of months = $ _____________

Monthly subscription added user (30 days) $19.00 U.S. ($29.00 Canadian) per added user

Number of added users ______ times $19.00 U.S. ($29.00 Canadian) times # of months _________ = $ _____________

( ) Taxrate.com Basic Subscription

Monthly subscription single user (30 days) $19.00 U.S. ($29.00 Canadian) times # _____ of months = $ _____________

Monthly subscription added user (30 days) $5.00 U.S. ($9.00 Canadian) per added user

Number of added users ______ times $5.00 U.S. ($9.00 Canadian) times # of months __________ = $ _____________

( ) Silver Subscription (get both ProMilesOnline.com and Taxrate.com)

Monthly subscription single user (30 days) $49.00 U.S. ($75.00 Canadian) times # _____ of months = $ _____________

Monthly subscription added user (30 days) $22.00 U.S. ($34.00 Canadian) per added user

Number of added users ______ times $5.00 U.S. ($9.00 Canadian) times # of months __________ = $ _____________

Subtotal $ _____________

Save money simply by how you pay!

( ) Take 10% off my amount I want to pay Quarterly Subtotal __________ x 0.10 = -$_____________

( ) Take 20% off my amount I want to pay BI-Yearly Subtotal __________ x 0.20 = -$_____________

( ) Take 30% off my amount I want to pay Yearly Subtotal ________ x 0.30 = -$_____________

(8.25% only for Texas Based Companies) Sales Tax $_____________

Total Amount $ _____________

 

Method of Payment: ( )Check/Money Order   ( )Credit Card
Payable to:
ProMiles Software Development Corp (PSDC)

I understand that the information that I obtain from the ProMilesOnline.com or Taxrate.com web site is copyrighted and owned by ProMiles Software Development Corporation (PSDC). I agree, I will not rebroadcast or retransmit any information I obtain from the above named web sites without written permission from PSDC. I also understand that I will be given a user name and password for each subscription I have and the user name and password will only allows(one) person/user access to that web site at any given time and if I need additional users I am aware I must pay an additional user subscription fee. I further understand I will be billed each month for the above selected subscription and if I choose to cancel my subscription, I must notify PSDC before the first day of the month for which is to be canceled.

Credit Card #:________________________________________________________________ Exp. Date:________________________

 

Signature:_____________________________________ Print: ____________________________________ Date:____/_____/_____

Fax to: 409-735-2808 Call: 800-324-8588 U.S. Office or 888-RD MILES (736-4537) Email: info@ promiles.com

Mail to: Post Office Box 398 Bridge City TX 77611