ORDER FORM



LINDO Systems Inc : Order Form

1415 N Dayton St, Chicago, IL 60622

Phone: 312 -988-7422

Personal Information

|First Name: |      |MI: |      |Last Name: |      |

|Title: |      |Company: |       |

|Email: |      |Telephone: |      |

Shipping Address

|Addrress1: |      |Address2: |      |

|City: |      |

Mode of Payment

| Wire Transfer |Credit Card |

| Payment Enclosed | Purchase Order Attached |

Credit Card Payment (If payment is through Credit Card)

|Name on the Card |      |Credit Card Number |      |

|Type of Credit Card |      |Expiration Date(mmyy) |      |

|Billing Address, if different from shipping address |

|Address1 |      |Address2 |      |

|City |      |State |      |Country |      |

|      |      |      |       |0[pic]0.00 |0.0[pic]0.00 |

|      |      |      |      |0[pic]0.00 |0.0[pic]0.00 |

|      |      |      |      |0[pic]0.00 |0.0[pic]0.00 |

|      |      |      |      |0[pic]0.00 |0.0[pic]0.00 |

|      |      |      |      |0[pic]0.00 |0.0[pic]0.00 |

|      |      |      |      |0[pic]0.00 |0.0[pic]0.00 |

|      |      |      |      |0[pic]0.00 |0.0[pic]0.00 |

|      |      |      |      |0[pic]0.00 |0.0[pic]0.00 |

|Subtotal |0.0[pic]0.00 |

|Shipping |      |

|Total for Non Illinois Residents |0.0[pic]0.00 |

|Tax for Illinois Residents |0.0[pic]0.00 |

|Total for Illinois Residents |0.0[pic]0.00 |

Instructions and Guidelines:

1. Personal Information: Customers are likely to be contacted on the address specified for authenticity of the order. Hence, all details entered should be accurate.

2. License Information: If you are a qualified for an Educational License, please select Educational, else select Standard.

3. Mode of Shipping: LINDO ships the products to both domestic and international destinations. All International orders can only choose International Shipping. Domestic orders have the option to choose the UPS Ground, 1 Day shipping or 2 Day Shipping.

4. Mode of Payment: If you are choosing Wire Transfer as your payment option, then please contact LINDO Systems at the contact information provided at the bottom of this page.

If you choose Credit Card as your payment option, then you are required to provide the credit card and billing details in the next section.

5. Product Selection: Please indicate completely the product you are ordering and the platform you intend to run it on.

Ex: Super LINGO/Linux64, Itanium/, (Barrier and Global)

The prices for Educational License differ from the prices for Standard License. Please refer the appropriate prices document available at to fill in the price information.

For an estimate of the shipping rates, refer the pricing document available at . Actual shipping costs may vary depending on the size of the order and the place of delivery. Please contact LINDO Systems for the exact shipping prices.

All shipments within Illinois will be subject to a sales tax of 9% on shipments within Illinois. International orders may further be subject to taxes and/or duties at the time of delivery and are responsibility of the recipient.

6. For all other queries, please contact us at:

| | |

|LINDO Systems Inc |Phone: 312-988-7422 |

|1415 N Dayton St |Email: sales@ |

|Chicago, IL 60622 | |

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