Fixed Price Order Form

This form contains all information necessary to price and order a fixed price annual Teledex subscription. Please print, complete and transmit this form to Real Data as indicated in "How to Order" below.
Attention: _________________________________________________________
Company: ________________________________________________________
Address: _________________________________________________________
Town: _______________________ State:______ Zip:___________
Phone: ______________________ Fax:______________________ Email: ______________

Teledex is priced by the maximum number of towns you want to include in your subscription and the number of computers from which you or your company will access Teledex. The first column in the table below shows the maximum number of towns and the other columns show the prices for the number of computers. Per computer means per computer used for access by the same individual or company. Passwords are issued and controlled per computer and may only be used on the computer for which they are issued. Prices include as much Teledex/PA-34 use as you want as long as you comply with the terms and conditions on this form and the web site. All prices shown are annual. Please call for shorter terms and/or 10+ computers.

# of Towns	1	2	3 - 4	5 - 9
10	225.00	292.00	405.00	517.00
15	265.00	344.00	477.00	609.00
20	305.00	396.00	549.00	701.00
25	345.00	448.00	621.00	793.00
30	385.00	500.00	693.00	885.00
35	425.00	552.00	765.00	977.00
40	465.00	604.00	837.00	1069.00
45	505.00	656.00	909.00	1161.00
Statewide	595.00	744.00	1071.00	1369.00

How to order:
1. Determine from column 1 the maximum number of towns you want. ………..……......……. ________________

2. Enter the number of computers you or your company will use to access Teledex ….…......… ________________

3. Enter the price from the table based on items 1 & 2 ………………………….....………… $_________________

5. Complete the items below as required.
MasterCard___Visa___ Name as it appears on Card ________________________________________________

Account No. ________/________/________/________ Expiration Date: _____/_____ 3 digits on back: ______

I/We/My Company (We) agree to the Teledex terms and conditions (T&Cs) on this form and as posted from time to time at real-data.com (the Teledex Site). If We do not agree with changes to the T&Cs if/when these are posted to the Site. We may cancel our account and receive a pro-rata refund.

6. Signature REQUIRED for all orders _______________________________________ Date ______________

7. Fax the completed and signed form to (603) 645-0072. All orders require an original signature so please mail the original (and payment if not by CC) to Real Data Corp., 103 Bay St, Manchester, NH 03104-3007 even if you have expedited your subscription by faxing it.

8. Call (603) 669-3822 or 800-578-1540 from 9:00 AM to 5:00 PM ET Monday - Friday to set up your ID and password(s).