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<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN">
<HTML>
<HEAD>
<META HTTP-EQUIV="CONTENT-TYPE" CONTENT="text/html; charset=windows-1252">
<TITLE>LinkPoint Central Transaction</TITLE>
<META NAME="GENERATOR" CONTENT="OpenOffice.org 1.1.2 (Win32)">
<META NAME="CREATED" CONTENT="20050517;17012288">
<META NAME="CHANGED" CONTENT="20050517;17062203">
<STYLE>
<!--
P.copyright { color: #212c47; font-family: "Verdana", "Arial", "Helvetica", sans-serif; font-size: 7pt }
A:link { text-decoration: none }
A:visited { text-decoration: none }
-->
</STYLE>
</HEAD>
<BODY LANG="en-US" DIR="LTR">
<CENTER>
<TABLE BORDER=0 CELLPADDING=4 CELLSPACING=2 STYLE="page-break-before: always">
<TR>
<TD WIDTH=445>
<P ALIGN=CENTER STYLE="font-style: normal; text-decoration: none">
<FONT COLOR="#336699"><FONT FACE="Arial"><FONT SIZE=6 STYLE="font-size: 25pt"><B>Order
Entry Form</B></FONT></FONT></FONT></P>
</TD>
</TR>
</TABLE>
</CENTER>
<CENTER>
<TABLE WIDTH=576 BORDER=0 CELLPADDING=0 CELLSPACING=2>
<TR>
<TD></TD>
<TD>
<P ALIGN=LEFT><SPAN STYLE="text-decoration: none"><SPAN STYLE="font-weight: medium"><SPAN STYLE="font-style: normal"><FONT SIZE=2 STYLE="font-size: 9pt"><FONT FACE="Arial"><FONT COLOR="#212c47"><A HREF="#"><SPAN STYLE="text-decoration: none"><SPAN STYLE="font-weight: medium"><SPAN STYLE="font-style: normal"><FONT SIZE=2><FONT FACE="Arial"><FONT COLOR="#26268a">Required
fields</FONT></FONT></FONT></SPAN></SPAN><FONT COLOR="#208a6b">
<SPAN STYLE="font-weight: medium"><SPAN STYLE="font-style: normal"><FONT SIZE=2><FONT FACE="Arial">Optional
fields </FONT></FONT></SPAN></SPAN></FONT></SPAN></A>
<A HREF="#" ONCLICK="javascript:expandAll(); return(false);"><IMG SRC="../../../../lpc/docs/images/arrowdown.gif" NAME="allimg" ALIGN=BOTTOM WIDTH=75 HEIGHT=38 BORDER=0></A></FONT></FONT></FONT></SPAN></SPAN></SPAN></P>
</TD>
<TD></TD>
</TR>
</TABLE>
</CENTER>
<CENTER>
<TABLE WIDTH=576 BORDER=0 CELLPADDING=4 CELLSPACING=2>
<TR>
<TD BGCOLOR="#336699">
<P><SPAN STYLE="background: #336699"><FONT COLOR="#ffffff"><A HREF="#" ONCLICK="javascript:expandSection(2); return(false);"><IMG SRC="../../../../lpc/docs/images/arrowdown.gif" NAME="orderimg" ALIGN=BOTTOM WIDTH=75 HEIGHT=38 BORDER=0></A><A HREF="#" ONCLICK="javascript:expandSection(2); return(false);"><B><SPAN STYLE="font-style: normal"><FONT SIZE=1 STYLE="font-size: 8pt"><FONT FACE="Arial">Order
Information </FONT></FONT></SPAN></B></A></FONT></SPAN>
</P>
</TD>
</TR>
</TABLE>
</CENTER>
<DIV ID="orderChild" DIR="LTR">
<FORM NAME="posForm" ACTION="" METHOD="POST" ONSUBMIT="return disableSubmit(this);">
<INPUT TYPE=HIDDEN NAME="pagetype">
<INPUT TYPE=HIDDEN NAME="prevnext" VALUE="postores">
<INPUT TYPE=HIDDEN NAME="vlptype">
<INPUT TYPE=HIDDEN NAME="vlp" VALUE="1">
<INPUT TYPE=HIDDEN NAME="testmode" VALUE="0">
<INPUT TYPE=HIDDEN NAME="storename" VALUE="878284">
<INPUT TYPE=HIDDEN NAME="check" VALUE="0">
<INPUT TYPE=HIDDEN NAME="itemaction">
<INPUT TYPE=HIDDEN NAME="dispcc">
<INPUT TYPE=HIDDEN NAME="dispvc">
<INPUT TYPE=HIDDEN NAME="refresh" VALUE="0">
<INPUT TYPE=HIDDEN NAME="periodicity">
<INPUT TYPE=HIDDEN NAME="_st" VALUE="3:071D4FAD122AD10D9C556164FB246E3D">
<INPUT TYPE=HIDDEN NAME="_si" VALUE="5:BF7488C46E7A868CD8F636E8EC91A7FCDB82696F832E6B545CB2E403991E15F4">
<INPUT TYPE=HIDDEN NAME="_sk" VALUE="3:64ABBD7390442C6A41F351570AAC5B09">
<CENTER>
<TABLE WIDTH=576 BORDER=0 CELLPADDING=2 CELLSPACING=2>
<TR>
<TD WIDTH=8></TD>
<TD WIDTH=251>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none"><A NAME="oidtitle"></A>
<FONT COLOR="#208a6b"><FONT FACE="Arial"><FONT SIZE=2>Order
number:</FONT></FONT></FONT></P>
</TD>
<TD>
<P><INPUT TYPE=TEXT NAME="oid" SIZE=40 MAXLENGTH=50></P>
</TD>
</TR>
<TR>
<TD WIDTH=8></TD>
<TD WIDTH=251>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none"><A NAME="ponumbertitle"></A>
<FONT COLOR="#208a6b"><FONT FACE="Arial"><FONT SIZE=2>Purchase
Order number:</FONT></FONT></FONT></P>
</TD>
<TD>
<P><INPUT TYPE=TEXT NAME="ponumber" SIZE=20 MAXLENGTH=30></P>
</TD>
</TR>
<TR>
<TD WIDTH=8></TD>
<TD WIDTH=251>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none"><A NAME="subtotaltitle"></A>
<FONT COLOR="#26268a"><FONT FACE="Arial"><FONT SIZE=2>Subtotal:</FONT></FONT></FONT></P>
</TD>
<TD>
<P><INPUT TYPE=TEXT NAME="subtotal" SIZE=20 MAXLENGTH=10 ONCHANGE="javascript:calc(1);"></P>
</TD>
</TR>
<TR>
<TD WIDTH=8></TD>
<TD WIDTH=251>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none"><A NAME="shippingtitle"></A>
<FONT COLOR="#208a6b"><FONT FACE="Arial"><FONT SIZE=2>Shipping
Amount:</FONT></FONT></FONT></P>
</TD>
<TD>
<P><INPUT TYPE=TEXT NAME="shipping" SIZE=20 MAXLENGTH=10 ONCHANGE="javascript:calc(1);"></P>
</TD>
</TR>
<TR>
<TD WIDTH=8></TD>
<TD WIDTH=251>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none">
<FONT COLOR="#208a6b"><FONT FACE="Arial"><FONT SIZE=2>Tax: </FONT></FONT></FONT>
</P>
</TD>
<TD>
<P><INPUT TYPE=TEXT NAME="tax" SIZE=20 MAXLENGTH=10 ONCHANGE="javascript:calc(1);"><INPUT TYPE=CHECKBOX NAME="taxexempt" VALUE="1" ONCLICK="javascript:setexempt();"><SPAN STYLE="text-decoration: none"><SPAN STYLE="font-weight: medium"><SPAN STYLE="font-style: normal"><FONT SIZE=2><FONT FACE="Arial"><FONT COLOR="#208a6b">Tax
Exempt</FONT></FONT></FONT></SPAN></SPAN></SPAN></P>
</TD>
</TR>
<TR>
<TD WIDTH=8></TD>
<TD WIDTH=251>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none"><A NAME="vattaxtitle"></A>
<FONT COLOR="#208a6b"><FONT FACE="Arial"><FONT SIZE=2>VAT(for
international orders):</FONT></FONT></FONT></P>
</TD>
<TD>
<P><INPUT TYPE=TEXT NAME="vattax" SIZE=20 MAXLENGTH=10 ONCHANGE="javascript:calc(1);"></P>
</TD>
</TR>
<TR>
<TD WIDTH=8></TD>
<TD WIDTH=251>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none"><A NAME="chargetotaltitle"></A>
<FONT COLOR="#26268a"><FONT FACE="Arial"><FONT SIZE=2>Total
Amount:</FONT></FONT></FONT></P>
</TD>
<TD>
<P><INPUT TYPE=TEXT NAME="chargetotal" SIZE=20 MAXLENGTH=10 ONCHANGE="javascript:calc(2);"><SPAN STYLE="text-decoration: none"><FONT COLOR="#212c47">
<SPAN STYLE="font-weight: medium"><SPAN STYLE="font-style: normal"><FONT SIZE=1 STYLE="font-size: 8pt"><FONT FACE="Arial">(tax
/vat /shipping included) </FONT></FONT></SPAN></SPAN></FONT></SPAN>
</P>
</TD>
</TR>
</TABLE>
</CENTER>
</DIV>
<CENTER>
<TABLE WIDTH=576 BORDER=0 CELLPADDING=2 CELLSPACING=2>
<TR>
<TD COLSPAN=3 BGCOLOR="#336699">
<P><A NAME="cctitle"></A><B><SPAN STYLE="font-style: normal"><FONT SIZE=1 STYLE="font-size: 8pt"><FONT FACE="Arial"><FONT COLOR="#ffffff">Pay
by: <SPAN STYLE="background: #336699"><FONT COLOR="#ffffff">
<A HREF="#" ONCLICK="javascript:expandSection(3); return(false);"><IMG SRC="../../../../lpc/docs/images/arrowover.gif" NAME="ccimg" ALT="Click to show/hide credit card fields. The text and arrow are highlighted if credit card is selected." ALIGN=BOTTOM WIDTH=75 HEIGHT=38 BORDER=0></A><A HREF="#" ONCLICK="javascript:expandSection(3); return(false);">
<SPAN STYLE="font-style: normal"><FONT SIZE=1 STYLE="font-size: 8pt"><FONT FACE="Arial">Credit
Card</FONT></FONT></SPAN></A></FONT></SPAN></FONT></FONT></FONT></SPAN></B></P>
</TD>
</TR>
</TABLE>
</CENTER>
<DIV ID="ccChild" DIR="LTR">
<CENTER>
<TABLE WIDTH=576 BORDER=0 CELLPADDING=2 CELLSPACING=2>
<TR>
<TD WIDTH=8></TD>
<TD>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none">
<FONT COLOR="#26268a"><FONT FACE="Arial"><FONT SIZE=2>Supported
card types:</FONT></FONT></FONT></P>
</TD>
<TD>
<P><SCRIPT LANGUAGE="JavaScript">
amex =0; diners =0; discover =0; jcb =0;
master =1; visa =1;
amex=0;
diners=0;
discover=0;
jcb=0;
master=1;
visa=1;
pageLoc="/lpc/docs/";
if(visa) document.write("<img height=24 src="+pageLoc+"images/visa.gif /> ");
if(master) document.write("<img height=24 src="+pageLoc+"images/mastercard.jpg /> ");
if(amex) document.write("<img height=24 src="+pageLoc+"images/amex.jpg /> ");
if(diners) document.write("<img height=24 src="+pageLoc+"images/diners.jpg /> ");
if(discover) document.write("<img height=24 src="+pageLoc+"images/discover.gif /> ");
if(jcb) document.write("<img height=24 src="+pageLoc+"images/jcb.gif />");
</SCRIPT><BR>
</P>
</TD>
</TR>
<TR>
<TD WIDTH=8></TD>
<TD>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none">
<FONT COLOR="#26268a"><FONT FACE="Arial"><FONT SIZE=2>Transaction
origin:</FONT></FONT></FONT></P>
</TD>
<TD>
<P STYLE="text-decoration: none"><FONT COLOR="#26268a"><SELECT NAME="txnorg" ONCHANGE="javascript:setretailfield();">
<OPTION VALUE="" SELECTED>Select one ....
<OPTION VALUE="moto">Mail Order/Telephone Order
<OPTION VALUE="retail">Retail (face to face)
<OPTION VALUE="eci">Electronic Commerce (internet)</OPTION>
</SELECT></FONT></P>
</TD>
</TR>
<TR>
<TD WIDTH=8></TD>
<TD WIDTH=251>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none">
<FONT COLOR="#26268a"><FONT FACE="Arial"><FONT SIZE=2>Transaction
type: </FONT></FONT></FONT>
</P>
</TD>
<TD>
<P STYLE="text-decoration: none"><FONT COLOR="#212c47"><SELECT NAME="txntype" ONCHANGE="javascript:showref(this);">
<OPTION VALUE="sale" SELECTED>Sale
<OPTION VALUE="preauth">Authorize Only
<OPTION VALUE="postauth">Forced Ticket</OPTION>
</SELECT></FONT></P>
</TD>
</TR>
<TR>
<TD WIDTH=8></TD>
<TD>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none">
<FONT COLOR="#208a6b"><FONT FACE="Arial"><FONT SIZE=2>Are you
swiping the card? </FONT></FONT></FONT>
</P>
</TD>
<TD>
<P STYLE="text-decoration: none"><FONT COLOR="#212c47"><INPUT TYPE=CHECKBOX NAME="swipe" VALUE="1" ONCLICK="javascript:checkSwipe(this);">
<SPAN STYLE="font-weight: medium"><SPAN STYLE="font-style: normal"><FONT SIZE=2 STYLE="font-size: 9pt"><FONT FACE="Arial">Yes
</FONT></FONT></SPAN></SPAN></FONT>
</P>
</TD>
</TR>
<TR>
<TD WIDTH=8></TD>
<TD>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none">
<FONT COLOR="#26268a"><FONT FACE="Arial"><FONT SIZE=2>Credit
card number: </FONT></FONT></FONT>
</P>
</TD>
<TD>
<P><A NAME="1"></A><A NAME="2"></A><INPUT TYPE=TEXT NAME="cardnumber" SIZE=25 MAXLENGTH=300><SCRIPT LANGUAGE="JavaScript">
number="";
if(!NS4)
document.write("<input class=text TYPE=password NAME=cardnumberp SIZE=25 MAXLENGTH=300 ONKEYDOWN=\"return checkKey(event);\" value='"+number+"'");
</SCRIPT></P>
</TD>
</TR>
<TR>
<TD WIDTH=8></TD>
<TD>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none"><A NAME="expdatetitle"></A>
<FONT COLOR="#26268a"><FONT FACE="Arial"><FONT SIZE=2>Expiration
date: </FONT></FONT></FONT>
</P>
</TD>
<TD>
<P STYLE="text-decoration: none"><FONT COLOR="#212c47"><SELECT NAME="expmonth">
<OPTION VALUE="01" SELECTED>01
<OPTION VALUE="02">02
<OPTION VALUE="03">03
<OPTION VALUE="04">04
<OPTION VALUE="05">05
<OPTION VALUE="06">06
<OPTION VALUE="07">07
<OPTION VALUE="08">08
<OPTION VALUE="09">09
<OPTION VALUE="10">10
<OPTION VALUE="11">11
<OPTION VALUE="12">12</OPTION>
</SELECT> <SPAN STYLE="font-weight: medium"><SPAN STYLE="font-style: normal"><FONT SIZE=2 STYLE="font-size: 9pt"><FONT FACE="Arial">/
<SELECT NAME="expyear">
<OPTION VALUE="2005" SELECTED>2005
<OPTION VALUE="2006">2006
<OPTION VALUE="2007">2007
<OPTION VALUE="2008">2008
<OPTION VALUE="2009">2009
<OPTION VALUE="2010">2010
<OPTION VALUE="2011">2011
<OPTION VALUE="2012">2012
<OPTION VALUE="2013">2013
<OPTION VALUE="2014">2014</OPTION>
</SELECT></FONT></FONT></SPAN></SPAN></FONT></P>
</TD>
</TR>
<TR>
<TD WIDTH=8></TD>
<TD>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none">
<FONT COLOR="#208a6b"><FONT FACE="Arial"><FONT SIZE=2>Card
Code:</FONT></FONT></FONT></P>
</TD>
<TD>
<P><INPUT TYPE=TEXT NAME="cvm" SIZE=4 MAXLENGTH=4><INPUT TYPE=CHECKBOX NAME="cvmnotpres" VALUE="1"><SPAN STYLE="text-decoration: none"><SPAN STYLE="font-weight: medium"><SPAN STYLE="font-style: normal"><FONT SIZE=2 STYLE="font-size: 9pt"><FONT FACE="Arial"><FONT COLOR="#212c47">Code
not on card</FONT></FONT></FONT></SPAN></SPAN></SPAN></P>
</TD>
</TR>
</TABLE>
</CENTER>
</DIV>
<DIV ID="reffieldChild" DIR="LTR">
<CENTER>
<TABLE WIDTH=576 BORDER=0 CELLPADDING=2 CELLSPACING=2>
<TR>
<TD WIDTH=8></TD>
<TD WIDTH=251>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none">
<FONT COLOR="#26268a"><FONT FACE="Arial"><FONT SIZE=2>Reference
Number(for Forced Ticket):</FONT></FONT></FONT></P>
</TD>
<TD>
<DIV ALIGN=LEFT>
<P><INPUT TYPE=TEXT NAME="refnum" SIZE=30 MAXLENGTH=6></P>
</DIV>
</TD>
</TR>
</TABLE>
</CENTER>
</DIV>
<DIV ID="vcChild" DIR="LTR">
<CENTER>
<TABLE WIDTH=576 BORDER=0 CELLPADDING=2 CELLSPACING=0>
<COL WIDTH=0>
<COL WIDTH=1>
<COL WIDTH=33>
<COL WIDTH=96>
<COL WIDTH=18>
<COL WIDTH=7>
<COL WIDTH=58>
<COL WIDTH=2>
<COL WIDTH=17>
<COL WIDTH=22>
<COL WIDTH=92>
<COL WIDTH=0>
<COL WIDTH=84>
<COL WIDTH=6>
<COL WIDTH=77>
<COL WIDTH=0>
<TR>
<TD ROWSPAN=6 WIDTH=0 VALIGN=TOP></TD>
<TD COLSPAN=11 WIDTH=386 HEIGHT=39>
<P><SCRIPT LANGUAGE="JavaScript">
pageLoc="/lpc/docs/";
var CompanyName = "ABTECH SCIENTIFIC, IN";
var start = new Image();
var chknum = new Image();
var amountimg = new Image();
var accountnum = new Image();
var routenum = new Image();
var MaxAmount = 9999.99;
start.src = pageLoc+"images/default.jpg";
chknum.src = pageLoc+"images/check_number.jpg";
amountimg.src = pageLoc+"images/check_amount.jpg";
accountnum.src = pageLoc+"images/account_number.jpg";
routenum.src = pageLoc+"images/routing_number.jpg";
var Units = new Array("One", "Two", "Three", "Four", "Five", "Six", "Seven", "Eight", "Nine");
var Teens = new Array("Ten", "Eleven", "Twelve", "Thirteen", "Fourteen", "Fifteen", "Sixteen", "Seventeen", "Eighteen", "Nineteen" );
var Tens = new Array("Ten", "Twenty", "Thirty", "Forty", "Fifty", "Sixty", "Seventy", "Eighty", "Ninety" );
var days = new Array('Sunday','Monday','Tuesday','Wednesday','Thursday','Friday','Saturday');
var months = new Array('Jan.','Feb.','March','April','May','June','July','Aug.','Sep.','Oct.','Nov.','Dec.');
// check if amount has valid format
function checkAmount(amount)
{
var i = 0;
var len = amount.length;
var cents_count = 0;
var dollars_count = 0;
var state = 1; // dollars
while ( i < len )
{
var c = amount.charAt(i);
if ( c == '.' )
{
state = 2; // cents
i++;
continue;
}
switch (state)
{
case 1: if ( isDigit(c) ) dollars_count++;
else return false;
//if ( dollars_count > 4 )return false;
break;
case 2: if ( isDigit (c) ) cents_count++;
else return false;
if ( cents_count > 2 ) return false;
break;
}
i++;
}
return true;
}
function spellUpTo100( amt )
{
if ( amt <= 0 ) return "";
else if ( 0 < amt && amt < 10 ) return Units[amt-1];
else if ( amt < 20 ) return Teens[amt-10];
else if ( amt < 100 )
{
var tens_amt = Math.floor( amt / 10 );
var units_amt = amt - tens_amt * 10;
if ( units_amt == 0 ) return Tens[tens_amt - 1];
else return Tens[tens_amt-1] + " " + Units[units_amt-1];
}
}
function spellUpTo1000( amt )
{
if ( amt < 100 ) return spellUpTo100( amt );
else if ( amt < 1000 ) // example: two hundred - forty five
{
var hundreds_amt = Math.floor( amt / 100 ); // 1...9
var upto_100_amt = amt - hundreds_amt * 100;
if ( upto_100_amt == 0 ) return Units[hundreds_amt-1] + " Hundred ";
else return Units[hundreds_amt-1] + " Hundred" + "-" + spellUpTo100(upto_100_amt);
}
}
function spellUpTo1M( amt )
{
if ( amt < 1000 ) return spellUpTo1000( amt );
else
{
var thousands_amt = Math.floor( amt / 1000 ); // 1...999
var upto_1000_amt = amt - thousands_amt * 1000;
if ( upto_1000_amt == 0 )
return spellUpTo1000( thousands_amt ) + " thousand ";
else
{
var last_3_digts = spellUpTo1000( upto_1000_amt );
if ( upto_1000_amt < 100 )
{
if ( upto_1000_amt == 0 )
return spellUpTo1000( thousands_amt ) + " thousand even";
else
return spellUpTo1000( thousands_amt ) + " thousand and " + spellUpTo1000( upto_1000_amt );
}
else return spellUpTo1000( thousands_amt ) + " Thousand-" + spellUpTo1000( upto_1000_amt );
}
}
}
function spellNumber( amt )
{
if ( amt < MaxAmount ) return spellUpTo1M( amt );
else return "Amount exceeding limit";
}
function spellItOut( dollars, cents )
{
var spelled_out = "";
var dollars_amt = parseInt(dollars); // no NaN here
var cents_amt = parseInt(cents,10);
if( dollars_amt == 0 )
{
if ( cents_amt == 0 ) return "Zero and 00/100";
else return "Zero and " + cents + "/100";
}
spelled_out = spellNumber( dollars_amt );
if ( dollars_amt < MaxAmount ){
if ( cents_amt == 0 ) spelled_out += " and no/100";
else spelled_out += " and " + cents + "/100";
}
return spelled_out;
}
function getSpelledAmount( amount )
{
var amt = parseFloat(amount);
if ( isNaN(amt) || checkAmount( amount ) == false )
{
//alert("Error:\n\nentry " + amount + " is not valid for a number");
return "Na";
}
var dot_index = amount.indexOf(".", 0);
var dollars = "";
var cents = "00";
if ( dot_index >= 0 )
{
dollars = amount.substr( 0, dot_index);
cents = amount.substr( dot_index+1, amount.length - dot_index - 1 );
if ( dollars.length == 0 ) dollars ="0";
if ( cents.length == 0 ) cents = "00";
else if ( cents.length == 1 ) cents = cents + "0"; // 3.2 will have cents = 20, but 3.02 will have cents = 2
}
else dollars = amount;
return spellItOut( dollars, cents );
}
function checkAmountFormat()
{
var amount = trim(document.posForm.CheckAmount.value);
var len = amount.length;
if ( len == 0 ) return false;
var idx;
var dot_index = -1;
var bad_count = 0;
var bad_chars = "";
var cents = "";
for ( idx = 0; idx < len; idx++ )
{
var ch = amount.charAt(idx);
if ( isDigit(ch) ) continue;
else if ( ch == '.' && dot_index == -1 )
{
dot_index = idx;
cents = amount.substring( dot_index + 1 );
}
else
{
bad_count++;
bad_chars += "\'" + ch + "\' ";
}
}
if ( bad_count > 0 )
{
var s1 = ( bad_count == 1 )? "s " : " ";
var s2 = ( bad_count > 1 )? "s " : " ";
alert("Error:\n\nAmount input contain" + s1 + bad_count + " invalid character" + s2 + ": " + bad_chars );
return false;
}
if ( cents.length > 2 )
{
alert("Error:\n\nThere are more than 2 digits in Cents input");
return false;
}
var amt = parseFloat(amount);
if ( amt > MaxAmount )
{
alert("Error:\n\n\Can't exceed " + MaxAmount );
return false;
}
return true;
}
function spellOutAmount(picimage)
{
doButtons(picimage);
var amount = trim(document.posForm.CheckAmount.value);
if(amount.length==0) {
document.posForm.spelledAmount.value="";
return false;
}
else if ( checkAmountFormat() == false ) {
document.posForm.spelledAmount.value="Na";
return false;
}
var spelled_out = getSpelledAmount(amount);
eval("document.posForm.spelledAmount.value = " + "'" + spelled_out + "'");
return true;
}
function clearSpelledAmount()
{
eval("document.posForm.spelledAmount.value = " + "' '");
}
function doButtons(picimage) {
eval("document['picture'].src = " + picimage + ".src");
}
function ChangeCheckAmount()
{
var amount = trim(document.posForm.CheckAmount.value);
document.posForm.chargetotal.value = amount;
if(amount.length==0) clearSpelledAmount();
else spellOutAmount('start');
calc(2);
}
function checkRoutingNumber()
{
var rn = trim(document.posForm.transitrouting.value);
var chk_len = 9;
// check length
if ( rn.length == 0) return true;
else if ( rn.length != chk_len )
{
alert("Error:\n\nRouting number must have exactly 9 digits");
return false;
}
// check for invalid digits
if ( containOnlyDigits("Routing Number", rn ) == false )
return false;
if ( rn == "000000000")
{
alert("Error:\n\nRouting Number can't be all zeros");
return false;
}
var s = rn.substr( 0, 8 );
// do the modulus-10 test here.
// first compute the weighted sum
var weights = new Array( 3, 7, 1, 3, 7, 1, 3, 7 ); // 8 weights
var sum = 0;
var idx;
for ( idx = 0; idx < chk_len-1; idx++ ) // i = 0..7 inclusive
{
var ch = s.charAt(idx);
sum += ch * weights[idx];
}
// compute the complement of modulus 10 of this sum
chk_digit = ( sum % 10 == 0 )? 0 : 10 - ( sum % 10 );
if ( rn.charAt(8,1) != chk_digit )
{
alert("Error:\n\nInvalid Routing Number - last digit doesn't match check digit " );
return false;
}
return true;
}
function checkAccountNumber()
{
var dda = trim(document.posForm.accountnumber.value);
var len = dda.length;
var digit_ok = true;
/*if ( len == 0 )
{
alert("Error:\n\nThe Account Number is blank");
return false;
}*/
var idx;
var bad_count = 0;
var bad_chars = "";
for ( idx = 0; idx < len; idx++ )
{
var c = dda.charAt(idx);
if ( idx == 0 )
{
if ( isDigit(c) )
continue;
else {
bad_count++;
bad_chars += "'" + dda.charAt(idx) + "' ";
}
}
else if ( isDigit(c) || ( c == '-' && isDigit(dda.charAt(idx-1)) ) )
continue;
else
{
bad_count++;
bad_chars += "'" + dda.charAt(idx) + "' ";
}
}
if ( bad_count == 0 ) {
if ( round(dda) == 0 && len != 0 )
{
alert("Error:\n\nAccount Number can't be all zeros");
return false;
}
return true;
}
else
{
var s = (bad_count == 1)? "" : "s";
alert("Error:\n\nAccount Number contains" + bad_count + " invalid character" + s + ": " + bad_chars );
return false;
}
}
function checkCheckNumber()
{
var cn = trim( document.posForm.checknumber.value );
if ( cn.length == 0 )
{
/*alert("Error:\n\nCheck Number is blank");
return false;*/ return true;
}else {
flag = containOnlyDigits("Check Number", cn );
if(flag) {
inum = parseInt(cn,10);
document.posForm.checknumber.value = inum;
if(inum == 0){
alert("Error:\n\nZero is not valid Check Number.");
return false;
}
}
return flag;
}
}
function validateInputs()
{
var amount = trim( document.posForm.CheckAmount.value );
if( amount.length == 0) {
alert("Error:\n\nCheck Amount is blank");
return false;
}
if(checkAmount(amount)==false){
alert("Error:\n\nCheck Amount: " + amount + " is not valid for a number");
return false;
}
if(checkAmountFormat()==false)return false;
var chk_check = checkCheckNumber();
var chk_rn = checkRoutingNumber();
var chk_dda = checkAccountNumber();
// return true;
//return ( chk_check && chk_amount && chk_rn && chk_dda && chk_store );
return ( chk_check && chk_rn && chk_dda);
}
function containOnlyDigits( name, str )
{
var bad_chars = "";
var bad_count = 0;
var len = str.length;
if ( len == 0 ) return false;
var idx;
for ( idx = 0; idx < len; idx++ )
{
var ch = str.charAt(idx);
if ( !isDigit( ch ) )
{
bad_chars += "\'" + ch + "\'" + " ";
bad_count++;
}
}
if ( bad_count > 0 )
{
var s = ( bad_count > 1 )? "s " : " ";
alert("Error:\n\n" + name + " contains " + bad_count + " invalid character" + s + ": " + bad_chars );
return false;
}
else return true;
}
function focusnext(evt) {
if(NS4) document.posForm.CheckAmount.focus();
else document.posForm.transitrouting.focus();
return true;
}
</SCRIPT><IMG SRC="../../../../lpc/docs/images/check03-2_01.jpg" NAME="Graphic1" ALIGN=BOTTOM WIDTH=390 HEIGHT=43 BORDER=0></P>
</TD>
<TD WIDTH=84 VALIGN=BOTTOM STYLE="background: url(../../../../lpc/docs/images/check03-2_02.jpg) repeat scroll">
<DIV ALIGN=CENTER>
<P><INPUT TYPE=TEXT NAME="checknumber" SIZE=6 MAXLENGTH=6 ONCHANGE="checkCheckNumber()"></P>
</DIV>
</TD>
<TD ROWSPAN=6 WIDTH=6 VALIGN=TOP></TD>
<TD ROWSPAN=7 COLSPAN=2 WIDTH=81 VALIGN=TOP>
<IMG SRC="../../../../lpc/docs/images/default.jpg" NAME="picture" ALIGN=LEFT WIDTH=75 HEIGHT=38 BORDER=0></TD>
</TR>
<TR>
<TD COLSPAN=11 WIDTH=386 VALIGN=TOP>
<TABLE WIDTH=386 BORDER=0 CELLPADDING=0 CELLSPACING=0>
<COL WIDTH=386>
<TR>
<TD WIDTH=386 HEIGHT=14 VALIGN=BOTTOM STYLE="background: url(../../../../lpc/docs/images/check03-2_03.jpg) repeat scroll">
<P ALIGN=RIGHT><SCRIPT LANGUAGE="Javascript">
var now = new Date();
var date = ((now.getDate()<10) ? "0" : "")+ now.getDate();
function fourdigits(number) {
return (number < 1000) ? number + 1900 : number;
}
today = months[now.getMonth()] + " " + date + ", " +
(fourdigits(now.getYear()));
document.write(today);
</SCRIPT> </P>
</TD>
</TR>
<TR>
<TD WIDTH=386 HEIGHT=33 VALIGN=BOTTOM STYLE="background: url(../../../../lpc/docs/images/check03-2_05.jpg) repeat scroll">
<P> <SCRIPT LANGUAGE="JavaScript">
if(NS4) eval("CompanyName = '????'+CompanyName");
document.write(CompanyName);
</SCRIPT></P>
</TD>
</TR>
</TABLE>
</TD>
<TD WIDTH=84 VALIGN=BOTTOM STYLE="background: url(../../../../lpc/docs/images/check03-2_04.jpg) repeat scroll">
<P><INPUT TYPE=TEXT NAME="CheckAmount" SIZE=8 MAXLENGTH=8 ONCHANGE="ChangeCheckAmount()"><INPUT TYPE=HIDDEN NAME="company" VALUE="ABTECH SCIENTIFIC, IN"></P>
</TD>
</TR>
<TR>
<TD COLSPAN=12 WIDTH=474 HEIGHT=22 VALIGN=BOTTOM STYLE="background: url(../../../../lpc/docs/images/check03-2_06.jpg) repeat scroll">
<P> <INPUT TYPE=TEXT NAME="spelledAmount" SIZE=58 ONFOCUS="return focusnext(event);"></P>
</TD>
</TR>
<TR>
<TD COLSPAN=12 WIDTH=474>
<P><IMG SRC="../../../../lpc/docs/images/check03-2_07.jpg" NAME="Graphic2" ALIGN=BOTTOM WIDTH=478 HEIGHT=64 BORDER=0></P>
</TD>
</TR>
<TR>
<TD COLSPAN=2 WIDTH=38 BGCOLOR="#ecedef" STYLE="background: #ecedef url(../../../../lpc/docs/images/bot_flr.gif) repeat scroll">
<P><IMG SRC="../../../../lpc/docs/images/check03-2_08_01.gif" NAME="Graphic3" ALIGN=BOTTOM WIDTH=42 HEIGHT=33 BORDER=0></P>
</TD>
<TD WIDTH=96 VALIGN=TOP BGCOLOR="#ecedef" STYLE="background: #ecedef url(../../../../lpc/docs/images/bot_flr.gif) repeat scroll">
<P><INPUT TYPE=TEXT NAME="transitrouting" SIZE=12 MAXLENGTH=9 ONCHANGE="checkRoutingNumber()"></P>
</TD>
<TD WIDTH=18 BGCOLOR="#ecedef" STYLE="background: #ecedef url(../../../../lpc/docs/images/bot_flr.gif) repeat scroll">
<P><IMG SRC="../../../../lpc/docs/images/check03-2_08_03.gif" NAME="Graphic4" ALIGN=BOTTOM WIDTH=22 HEIGHT=33 BORDER=0></P>
</TD>
<TD COLSPAN=4 WIDTH=96 VALIGN=TOP BGCOLOR="#cbdef6" STYLE="background: #cbdef6 url(../../../../lpc/docs/images/bot_flr.gif) repeat scroll">
<P><INPUT TYPE=TEXT NAME="accountnumber" SIZE=12 MAXLENGTH=17 ONCHANGE="checkAccountNumber()"></P>
</TD>
<TD WIDTH=22 BGCOLOR="#ecedef" STYLE="background: #ecedef url(../../../../lpc/docs/images/bot_flr.gif) repeat scroll">
<P><IMG SRC="../../../../lpc/docs/images/check03-2_08_05.gif" NAME="Graphic5" ALIGN=BOTTOM WIDTH=26 HEIGHT=33 BORDER=0></P>
</TD>
<TD COLSPAN=3 WIDTH=184 VALIGN=TOP></TD>
</TR>
<TR>
<TD COLSPAN=12 WIDTH=474 VALIGN=TOP></TD>
</TR>
<TR>
<TD COLSPAN=14 WIDTH=487></TD>
</TR>
<TR>
<TD ROWSPAN=11 WIDTH=0 VALIGN=TOP></TD>
<TD WIDTH=1></TD>
<TD COLSPAN=4 WIDTH=166>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none">
<FONT COLOR="#26268a"><FONT FACE="Arial"><FONT SIZE=2>Transaction
origin:</FONT></FONT></FONT></P>
</TD>
<TD COLSPAN=5 WIDTH=207>
<P STYLE="text-decoration: none"><FONT COLOR="#26268a"><SELECT NAME="txnorgvc" ONCHANGE="javascript:settxnorgvc();">
<OPTION VALUE="" SELECTED>Select one ....
<OPTION VALUE="eci">Electronic Commerce (internet)
<OPTION VALUE="moto">Telephone Order
<OPTION VALUE="retail">Retail/ Mail Order</OPTION>
</SELECT></FONT></P>
</TD>
<TD COLSPAN=4 WIDTH=178 VALIGN=TOP></TD>
<TD ROWSPAN=11 WIDTH=0 VALIGN=TOP></TD>
</TR>
<TR>
<TD WIDTH=1></TD>
<TD COLSPAN=9 WIDTH=377 VALIGN=TOP></TD>
<TD COLSPAN=4 WIDTH=178 VALIGN=TOP></TD>
</TR>
<TR>
<TD WIDTH=1></TD>
<TD COLSPAN=4 WIDTH=166>
<P ALIGN=LEFT STYLE="font-style: normal; font-weight: medium; text-decoration: none">
<FONT COLOR="#26268a"><FONT FACE="Arial"><FONT SIZE=2>Account
Type: </FONT></FONT></FONT>
</P>
</TD>
<TD COLSPAN=5 WIDTH=207>
<DIV ALIGN=LEFT>
<P STYLE="text-decoration: none"><FONT COLOR="#212c47"><SELECT NAME="accounttype">
<OPTION VALUE="pc" SELECTED>Personal checking
<OPTION VALUE="ps">Personal savings
<OPTION VALUE="bc">Business checking
<OPTION VALUE="bs">Business savings</OPTION>
</SELECT></FONT></P>
</DIV>
</TD>
<TD COLSPAN=4 WIDTH=178>
<P> </P>
</TD>
</TR>
<TR>
<TD WIDTH=1></TD>
<TD COLSPAN=13 WIDTH=559 VALIGN=TOP></TD>
</TR>
<TR>
<TD WIDTH=1></TD>
<TD COLSPAN=4 WIDTH=166>
<P ALIGN=LEFT STYLE="font-style: normal; font-weight: medium; text-decoration: none">
<FONT COLOR="#26268a"><FONT FACE="Arial"><FONT SIZE=2>Drivers
License: </FONT></FONT></FONT>
</P>
</TD>
<TD COLSPAN=9 WIDTH=389>
<DIV ALIGN=LEFT>
<P STYLE="text-decoration: none"><FONT COLOR="#212c47"><INPUT TYPE=TEXT NAME="dlnumber" SIZE=30 MAXLENGTH=35></FONT></P>
</DIV>
</TD>
</TR>
<TR>
<TD ROWSPAN=2 WIDTH=1></TD>
<TD ROWSPAN=2 COLSPAN=4 WIDTH=166>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none"><A NAME="dlstatetitle"></A>
<FONT COLOR="#26268a"><FONT FACE="Arial"><FONT SIZE=2>Drivers
License State:</FONT></FONT></FONT></P>
</TD>
<TD WIDTH=58>
<P STYLE="text-decoration: none"><FONT COLOR="#212c47"><SELECT NAME="dlstate">
<OPTION VALUE="" SELECTED>...
<OPTION VALUE="AK">AK
<OPTION VALUE="AL">AL
<OPTION VALUE="AR">AR
<OPTION VALUE="AZ">AZ
<OPTION VALUE="CA">CA
<OPTION VALUE="CO">CO
<OPTION VALUE="CT">CT
<OPTION VALUE="DC">DC
<OPTION VALUE="DE">DE
<OPTION VALUE="FL">FL
<OPTION VALUE="GA">GA
<OPTION VALUE="HI">HI
<OPTION VALUE="IA">IA
<OPTION VALUE="ID">ID
<OPTION VALUE="IL">IL
<OPTION VALUE="IN">IN
<OPTION VALUE="KS">KS
<OPTION VALUE="KY">KY
<OPTION VALUE="LA">LA
<OPTION VALUE="MA">MA
<OPTION VALUE="MD">MD
<OPTION VALUE="ME">ME
<OPTION VALUE="MI">MI
<OPTION VALUE="MN">MN
<OPTION VALUE="MO">MO
<OPTION VALUE="MS">MS
<OPTION VALUE="MT">MT
<OPTION VALUE="NC">NC
<OPTION VALUE="ND">ND
<OPTION VALUE="NE">NE
<OPTION VALUE="NH">NH
<OPTION VALUE="NJ">NJ
<OPTION VALUE="NM">NM
<OPTION VALUE="NV">NV
<OPTION VALUE="NY">NY
<OPTION VALUE="OH">OH
<OPTION VALUE="OK">OK
<OPTION VALUE="OR">OR
<OPTION VALUE="PA">PA
<OPTION VALUE="PR">PR
<OPTION VALUE="RI">RI
<OPTION VALUE="SC">SC
<OPTION VALUE="SD">SD
<OPTION VALUE="TN">TN
<OPTION VALUE="TX">TX
<OPTION VALUE="UT">UT
<OPTION VALUE="VA">VA
<OPTION VALUE="VI">VI
<OPTION VALUE="VT">VT
<OPTION VALUE="WA">WA
<OPTION VALUE="WI">WI
<OPTION VALUE="WV">WV
<OPTION VALUE="WY">WY</OPTION>
</SELECT></FONT></P>
</TD>
<TD WIDTH=2></TD>
<TD COLSPAN=3 WIDTH=139 VALIGN=TOP></TD>
<TD ROWSPAN=2 COLSPAN=4 WIDTH=178 VALIGN=TOP></TD>
</TR>
<TR>
<TD COLSPAN=5 WIDTH=207></TD>
</TR>
<TR>
<TD WIDTH=1></TD>
<TD COLSPAN=4 WIDTH=166>
<P ALIGN=LEFT STYLE="font-style: normal; font-weight: medium; text-decoration: none">
<FONT COLOR="#26268a"><FONT FACE="Arial"><FONT SIZE=2>Bank
Name: </FONT></FONT></FONT>
</P>
</TD>
<TD COLSPAN=9 WIDTH=389>
<DIV ALIGN=LEFT>
<P STYLE="text-decoration: none"><FONT COLOR="#212c47"><INPUT TYPE=TEXT NAME="bankname" SIZE=30 MAXLENGTH=30></FONT></P>
</DIV>
</TD>
</TR>
<TR>
<TD ROWSPAN=2 WIDTH=1></TD>
<TD ROWSPAN=2 COLSPAN=4 WIDTH=166>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none"><A NAME="bankstatetitle"></A>
<FONT COLOR="#26268a"><FONT FACE="Arial"><FONT SIZE=2>Bank
State:</FONT></FONT></FONT></P>
</TD>
<TD WIDTH=58>
<P STYLE="text-decoration: none"><FONT COLOR="#212c47"><SELECT NAME="bankstate">
<OPTION VALUE="" SELECTED>...
<OPTION VALUE="AK">AK
<OPTION VALUE="AL">AL
<OPTION VALUE="AR">AR
<OPTION VALUE="AZ">AZ
<OPTION VALUE="CA">CA
<OPTION VALUE="CO">CO
<OPTION VALUE="CT">CT
<OPTION VALUE="DC">DC
<OPTION VALUE="DE">DE
<OPTION VALUE="FL">FL
<OPTION VALUE="GA">GA
<OPTION VALUE="HI">HI
<OPTION VALUE="IA">IA
<OPTION VALUE="ID">ID
<OPTION VALUE="IL">IL
<OPTION VALUE="IN">IN
<OPTION VALUE="KS">KS
<OPTION VALUE="KY">KY
<OPTION VALUE="LA">LA
<OPTION VALUE="MA">MA
<OPTION VALUE="MD">MD
<OPTION VALUE="ME">ME
<OPTION VALUE="MI">MI
<OPTION VALUE="MN">MN
<OPTION VALUE="MO">MO
<OPTION VALUE="MS">MS
<OPTION VALUE="MT">MT
<OPTION VALUE="NC">NC
<OPTION VALUE="ND">ND
<OPTION VALUE="NE">NE
<OPTION VALUE="NH">NH
<OPTION VALUE="NJ">NJ
<OPTION VALUE="NM">NM
<OPTION VALUE="NV">NV
<OPTION VALUE="NY">NY
<OPTION VALUE="OH">OH
<OPTION VALUE="OK">OK
<OPTION VALUE="OR">OR
<OPTION VALUE="PA">PA
<OPTION VALUE="PR">PR
<OPTION VALUE="RI">RI
<OPTION VALUE="SC">SC
<OPTION VALUE="SD">SD
<OPTION VALUE="TN">TN
<OPTION VALUE="TX">TX
<OPTION VALUE="UT">UT
<OPTION VALUE="VA">VA
<OPTION VALUE="VI">VI
<OPTION VALUE="VT">VT
<OPTION VALUE="WA">WA
<OPTION VALUE="WI">WI
<OPTION VALUE="WV">WV
<OPTION VALUE="WY">WY</OPTION>
</SELECT></FONT></P>
</TD>
<TD WIDTH=2></TD>
<TD COLSPAN=3 WIDTH=139 VALIGN=TOP></TD>
<TD ROWSPAN=2 COLSPAN=4 WIDTH=178 VALIGN=TOP></TD>
</TR>
<TR>
<TD COLSPAN=5 WIDTH=207></TD>
</TR>
<TR>
<TD WIDTH=1></TD>
<TD COLSPAN=4 WIDTH=166>
<P ALIGN=LEFT STYLE="font-style: normal; font-weight: medium; text-decoration: none">
<FONT COLOR="#208a6b"><FONT FACE="Arial"><FONT SIZE=2>Social
Security Number: </FONT></FONT></FONT>
</P>
</TD>
<TD COLSPAN=9 WIDTH=389>
<DIV ALIGN=LEFT>
<P STYLE="text-decoration: none"><FONT COLOR="#212c47"><INPUT TYPE=TEXT NAME="ssn" SIZE=30 MAXLENGTH=15><INPUT TYPE=HIDDEN NAME="vcagree" VALUE="1"><INPUT TYPE=HIDDEN NAME="micr"></FONT></P>
</DIV>
</TD>
</TR>
<TR>
<TD COLSPAN=16 WIDTH=572></TD>
</TR>
</TABLE>
</CENTER>
</DIV>
<CENTER>
<TABLE WIDTH=576 BORDER=0 CELLPADDING=2 CELLSPACING=2>
<TR>
<TD BGCOLOR="#336699">
<P><A NAME="baddtitle"></A><SPAN STYLE="background: #336699"><FONT COLOR="#ffffff"><A HREF="#" ONCLICK="javascript:expandSection(5); return(false);"><IMG SRC="../../../../lpc/docs/images/arrowover.gif" NAME="baddimg" ALIGN=BOTTOM WIDTH=75 HEIGHT=38 BORDER=0></A><A HREF="#" ONCLICK="javascript:expandSection(5); return(false);"><B><SPAN STYLE="font-style: normal"><FONT SIZE=1 STYLE="font-size: 8pt"><FONT FACE="Arial">Customer
Contact Information </FONT></FONT></SPAN></B></A></FONT></SPAN>
</P>
</TD>
</TR>
</TABLE>
</CENTER>
<DIV ID="baddChild" DIR="LTR">
<CENTER>
<TABLE WIDTH=576 BORDER=0 CELLPADDING=2 CELLSPACING=0>
<COL WIDTH=7>
<COL WIDTH=253>
<COL WIDTH=0>
<COL WIDTH=58>
<COL WIDTH=0>
<COL WIDTH=62>
<COL WIDTH=164>
<COL WIDTH=0>
<TR>
<TD WIDTH=7></TD>
<TD WIDTH=253>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none"><A NAME="custidtitle"></A>
<FONT COLOR="#208a6b"><FONT FACE="Arial"><FONT SIZE=2>Customer
ID Number:</FONT></FONT></FONT></P>
</TD>
<TD COLSPAN=6 WIDTH=304>
<P><INPUT TYPE=TEXT NAME="custid" SIZE=32 MAXLENGTH=32></P>
</TD>
</TR>
<TR>
<TD WIDTH=7></TD>
<TD WIDTH=253>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none"><A NAME="bnametitle"></A>
<FONT COLOR="#26268a"><FONT FACE="Arial"><FONT SIZE=2>Customer
name:</FONT></FONT></FONT></P>
</TD>
<TD COLSPAN=6 WIDTH=304>
<P><INPUT TYPE=TEXT NAME="bname" SIZE=36 MAXLENGTH=36></P>
</TD>
</TR>
<TR>
<TD WIDTH=7></TD>
<TD WIDTH=253>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none"><A NAME="bcompanytitle"></A>
<FONT COLOR="#208a6b"><FONT FACE="Arial"><FONT SIZE=2>Billing
company:</FONT></FONT></FONT></P>
</TD>
<TD COLSPAN=6 WIDTH=304>
<P><INPUT TYPE=TEXT NAME="bcompany" SIZE=20 MAXLENGTH=30></P>
</TD>
</TR>
<TR>
<TD WIDTH=7></TD>
<TD WIDTH=253>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none"><A NAME="baddr1title"></A>
<FONT COLOR="#26268a"><FONT FACE="Arial"><FONT SIZE=2>Billing
street address:</FONT></FONT></FONT></P>
</TD>
<TD COLSPAN=6 WIDTH=304>
<P><INPUT TYPE=TEXT NAME="baddr1" SIZE=36 MAXLENGTH=30></P>
</TD>
</TR>
<TR>
<TD WIDTH=7></TD>
<TD WIDTH=253></TD>
<TD COLSPAN=6 WIDTH=304>
<P><INPUT TYPE=TEXT NAME="baddr2" SIZE=36 MAXLENGTH=30></P>
</TD>
</TR>
<TR>
<TD WIDTH=7></TD>
<TD WIDTH=253>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none"><A NAME="bcitytitle"></A>
<FONT COLOR="#26268a"><FONT FACE="Arial"><FONT SIZE=2>City:</FONT></FONT></FONT></P>
</TD>
<TD COLSPAN=6 WIDTH=304>
<P><INPUT TYPE=TEXT NAME="bcity" SIZE=36 MAXLENGTH=30></P>
</TD>
</TR>
<TR>
<TD ROWSPAN=2 WIDTH=7></TD>
<TD ROWSPAN=2 WIDTH=253>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none"><A NAME="bstatetitle"></A>
<FONT COLOR="#26268a"><FONT FACE="Arial"><FONT SIZE=2>State:</FONT></FONT></FONT></P>
</TD>
<TD WIDTH=0 VALIGN=TOP></TD>
<TD WIDTH=58>
<P STYLE="text-decoration: none"><FONT COLOR="#212c47"><SELECT NAME="bstate">
<OPTION VALUE="" SELECTED>...
<OPTION VALUE="AK">AK
<OPTION VALUE="AL">AL
<OPTION VALUE="AR">AR
<OPTION VALUE="AZ">AZ
<OPTION VALUE="CA">CA
<OPTION VALUE="CO">CO
<OPTION VALUE="CT">CT
<OPTION VALUE="DC">DC
<OPTION VALUE="DE">DE
<OPTION VALUE="FL">FL
<OPTION VALUE="GA">GA
<OPTION VALUE="HI">HI
<OPTION VALUE="IA">IA
<OPTION VALUE="ID">ID
<OPTION VALUE="IL">IL
<OPTION VALUE="IN">IN
<OPTION VALUE="KS">KS
<OPTION VALUE="KY">KY
<OPTION VALUE="LA">LA
<OPTION VALUE="MA">MA
<OPTION VALUE="MD">MD
<OPTION VALUE="ME">ME
<OPTION VALUE="MI">MI
<OPTION VALUE="MN">MN
<OPTION VALUE="MO">MO
<OPTION VALUE="MS">MS
<OPTION VALUE="MT">MT
<OPTION VALUE="NC">NC
<OPTION VALUE="ND">ND
<OPTION VALUE="NE">NE
<OPTION VALUE="NH">NH
<OPTION VALUE="NJ">NJ
<OPTION VALUE="NM">NM
<OPTION VALUE="NV">NV
<OPTION VALUE="NY">NY
<OPTION VALUE="OH">OH
<OPTION VALUE="OK">OK
<OPTION VALUE="OR">OR
<OPTION VALUE="PA">PA
<OPTION VALUE="PR">PR
<OPTION VALUE="RI">RI
<OPTION VALUE="SC">SC
<OPTION VALUE="SD">SD
<OPTION VALUE="TN">TN
<OPTION VALUE="TX">TX
<OPTION VALUE="UT">UT
<OPTION VALUE="VA">VA
<OPTION VALUE="VI">VI
<OPTION VALUE="VT">VT
<OPTION VALUE="WA">WA
<OPTION VALUE="WI">WI
<OPTION VALUE="WV">WV
<OPTION VALUE="WY">WY</OPTION>
</SELECT></FONT></P>
</TD>
<TD WIDTH=0></TD>
<TD WIDTH=62>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none">
<FONT COLOR="#208a6b"><FONT FACE="Arial"><FONT SIZE=2>or
Province:</FONT></FONT></FONT></P>
</TD>
<TD WIDTH=164>
<P><INPUT TYPE=TEXT NAME="bstate2" SIZE=20 MAXLENGTH=30 ONCHANGE="javascript:blankstate(this);"></P>
</TD>
<TD WIDTH=0 VALIGN=TOP></TD>
</TR>
<TR>
<TD COLSPAN=6 WIDTH=304></TD>
</TR>
<TR>
<TD WIDTH=7></TD>
<TD WIDTH=253>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none"><A NAME="bcountrytitle"></A>
<FONT COLOR="#26268a"><FONT FACE="Arial"><FONT SIZE=2>Country:</FONT></FONT></FONT></P>
</TD>
<TD COLSPAN=6 WIDTH=304>
<P><SELECT NAME="bcountry" ONCHANGE="javascript:blankstate(this);">
<OPTION VALUE="">...
<OPTION VALUE="AF">Afghanistan
<OPTION VALUE="AL">Albania
<OPTION VALUE="DZ">Algeria
<OPTION VALUE="AS">American Samoa
<OPTION VALUE="AD">Andorra
<OPTION VALUE="AO">Angola
<OPTION VALUE="AI">Anguilla
<OPTION VALUE="AQ">Antarctica
<OPTION VALUE="AG">Antigua And Barbuda
<OPTION VALUE="AR">Argentina
<OPTION VALUE="AM">Armenia
<OPTION VALUE="AW">Aruba
<OPTION VALUE="AU">Australia
<OPTION VALUE="AT">Austria
<OPTION VALUE="AZ">Azerbaijan
<OPTION VALUE="BS">Bahamas
<OPTION VALUE="BH">Bahrain
<OPTION VALUE="BD">Bangladesh
<OPTION VALUE="BB">Barbados
<OPTION VALUE="BY">Belarus
<OPTION VALUE="BE">Belgium
<OPTION VALUE="BZ">Belize
<OPTION VALUE="BJ">Benin
<OPTION VALUE="BM">Bermuda
<OPTION VALUE="BT">Bhutan
<OPTION VALUE="BO">Bolivia
<OPTION VALUE="BA">Bosnia And Herzegowina
<OPTION VALUE="BW">Botswana
<OPTION VALUE="BV">Bouvet Island
<OPTION VALUE="BR">Brazil
<OPTION VALUE="IO">British Indian Ocean Territory
<OPTION VALUE="BN">Brunei Darussalam
<OPTION VALUE="BG">Bulgaria
<OPTION VALUE="BF">Burkina Faso
<OPTION VALUE="BI">Burundi
<OPTION VALUE="KH">Cambodia
<OPTION VALUE="CM">Cameroon
<OPTION VALUE="CA">Canada
<OPTION VALUE="CV">Cape Verde
<OPTION VALUE="KY">Cayman Islands
<OPTION VALUE="CF">Central African Republic
<OPTION VALUE="TD">Chad
<OPTION VALUE="CL">Chile
<OPTION VALUE="CN">China
<OPTION VALUE="CX">Christmas Island
<OPTION VALUE="CC">Cocos (Keeling) Islands
<OPTION VALUE="CO">Colombia
<OPTION VALUE="KM">Comoros
<OPTION VALUE="CG">Congo
<OPTION VALUE="CK">Cook Islands
<OPTION VALUE="CR">Costa Rica
<OPTION VALUE="CI">Cote D'Ivoire
<OPTION VALUE="HR">Croatia
<OPTION VALUE="CU">Cuba
<OPTION VALUE="CY">Cyprus
<OPTION VALUE="CZ">Czech Republic
<OPTION VALUE="DK">Denmark
<OPTION VALUE="DJ">Djibouti
<OPTION VALUE="DM">Dominica
<OPTION VALUE="DO">Dominican Republic
<OPTION VALUE="TP">East Timor
<OPTION VALUE="EC">Ecuador
<OPTION VALUE="EG">Egypt
<OPTION VALUE="SV">El Salvador
<OPTION VALUE="GQ">Equatorial Guinea
<OPTION VALUE="ER">Eritrea
<OPTION VALUE="EE">Estonia
<OPTION VALUE="ET">Ethiopia
<OPTION VALUE="FK">Falkland Islands
<OPTION VALUE="FO">Faroe Islands
<OPTION VALUE="FJ">Fiji
<OPTION VALUE="FI">Finland
<OPTION VALUE="FR">France
<OPTION VALUE="FX">France, Metropolitan
<OPTION VALUE="GF">French Guiana
<OPTION VALUE="PF">French Polynesia
<OPTION VALUE="TF">French Southern Territories
<OPTION VALUE="GA">Gabon
<OPTION VALUE="GM">Gambia
<OPTION VALUE="GE">Georgia
<OPTION VALUE="DE">Germany
<OPTION VALUE="GH">Ghana
<OPTION VALUE="GI">Gibraltar
<OPTION VALUE="GR">Greece
<OPTION VALUE="GL">Greenland
<OPTION VALUE="GD">Grenada
<OPTION VALUE="GP">Guadeloupe
<OPTION VALUE="GU">Guam
<OPTION VALUE="GT">Guatemala
<OPTION VALUE="GN">Guinea
<OPTION VALUE="GW">Guinea-Bissau
<OPTION VALUE="GY">Guyana
<OPTION VALUE="HT">Haiti
<OPTION VALUE="HM">Heard And Mc Donald Islands
<OPTION VALUE="HN">Honduras
<OPTION VALUE="HK">Hong Kong
<OPTION VALUE="HU">Hungary
<OPTION VALUE="IS">Iceland
<OPTION VALUE="IN">India
<OPTION VALUE="ID">Indonesia
<OPTION VALUE="IR">Iran
<OPTION VALUE="IQ">Iraq
<OPTION VALUE="IE">Ireland
<OPTION VALUE="IL">Israel
<OPTION VALUE="IT">Italy
<OPTION VALUE="JM">Jamaica
<OPTION VALUE="JP">Japan
<OPTION VALUE="JO">Jordan
<OPTION VALUE="KZ">Kazakhstan
<OPTION VALUE="KE">Kenya
<OPTION VALUE="KI">Kiribati
<OPTION VALUE="KP">North Korea
<OPTION VALUE="KR">South Korea
<OPTION VALUE="KW">Kuwait
<OPTION VALUE="KG">Kyrgyzstan
<OPTION VALUE="LA">Lao People's Republic
<OPTION VALUE="LV">Latvia
<OPTION VALUE="LB">Lebanon
<OPTION VALUE="LS">Lesotho
<OPTION VALUE="LR">Liberia
<OPTION VALUE="LY">Libyan Arab Jamahiriya
<OPTION VALUE="LI">Liechtenstein
<OPTION VALUE="LT">Lithuania
<OPTION VALUE="LU">Luxembourg
<OPTION VALUE="MO">Macau
<OPTION VALUE="MK">Macedonia
<OPTION VALUE="MG">Madagascar
<OPTION VALUE="MW">Malawi
<OPTION VALUE="MY">Malaysia
<OPTION VALUE="MV">Maldives
<OPTION VALUE="ML">Mali
<OPTION VALUE="MT">Malta
<OPTION VALUE="MH">Marshall Islands
<OPTION VALUE="MQ">Martinique
<OPTION VALUE="MR">Mauritania
<OPTION VALUE="MU">Mauritius
<OPTION VALUE="YT">Mayotte
<OPTION VALUE="MX">Mexico
<OPTION VALUE="FM">Micronesia
<OPTION VALUE="MD">Moldova
<OPTION VALUE="MC">Monaco
<OPTION VALUE="MN">Mongolia
<OPTION VALUE="MS">Montserrat
<OPTION VALUE="MA">Morocco
<OPTION VALUE="MZ">Mozambique
<OPTION VALUE="MM">Myanmar
<OPTION VALUE="NA">Namibia
<OPTION VALUE="NR">Nauru
<OPTION VALUE="NP">Nepal
<OPTION VALUE="NL">Netherlands
<OPTION VALUE="AN">Netherlands Antilles
<OPTION VALUE="NC">New Caledonia
<OPTION VALUE="NZ">New Zealand
<OPTION VALUE="NI">Nicaragua
<OPTION VALUE="NE">Niger
<OPTION VALUE="NG">Nigeria
<OPTION VALUE="NU">Niue
<OPTION VALUE="NF">Norfolk Island
<OPTION VALUE="MP">Northern Mariana Islands
<OPTION VALUE="NO">Norway
<OPTION VALUE="OM">Oman
<OPTION VALUE="PK">Pakistan
<OPTION VALUE="PW">Palau
<OPTION VALUE="PA">Panama
<OPTION VALUE="PG">Papua New Guinea
<OPTION VALUE="PY">Paraguay
<OPTION VALUE="PE">Peru
<OPTION VALUE="PH">Philippines
<OPTION VALUE="PN">Pitcairn
<OPTION VALUE="PL">Poland
<OPTION VALUE="PT">Portugal
<OPTION VALUE="PR">Puerto Rico
<OPTION VALUE="QA">Qatar
<OPTION VALUE="RE">Reunion
<OPTION VALUE="RO">Romania
<OPTION VALUE="RU">Russian Federation
<OPTION VALUE="RW">Rwanda
<OPTION VALUE="KN">Saint Kitts And Nevis
<OPTION VALUE="LC">Saint Lucia
<OPTION VALUE="VC">Saint Vincent And The Grenadines
<OPTION VALUE="WS">Samoa
<OPTION VALUE="SM">San Marino
<OPTION VALUE="ST">Sao Tome And Principe
<OPTION VALUE="SA">Saudi Arabia
<OPTION VALUE="SN">Senegal
<OPTION VALUE="SC">Seychelles
<OPTION VALUE="SL">Sierra Leone
<OPTION VALUE="SG">Singapore
<OPTION VALUE="SK">Slovakia
<OPTION VALUE="SI">Slovenia
<OPTION VALUE="SB">Solomon Islands
<OPTION VALUE="SO">Somalia
<OPTION VALUE="ZA">South Africa
<OPTION VALUE="GS">South Georgia & South Sandwich Islands
<OPTION VALUE="ES">Spain
<OPTION VALUE="LK">Sri Lanka
<OPTION VALUE="SH">St Helena
<OPTION VALUE="PM">St Pierre and Miquelon
<OPTION VALUE="SD">Sudan
<OPTION VALUE="SR">Suriname
<OPTION VALUE="SJ">Svalbard And Jan Mayen Islands
<OPTION VALUE="SZ">Swaziland
<OPTION VALUE="SE">Sweden
<OPTION VALUE="CH">Switzerland
<OPTION VALUE="SY">Syrian Arab Republic
<OPTION VALUE="TW">Taiwan
<OPTION VALUE="TJ">Tajikistan
<OPTION VALUE="TZ">Tanzania
<OPTION VALUE="TH">Thailand
<OPTION VALUE="TG">Togo
<OPTION VALUE="TK">Tokelau
<OPTION VALUE="TO">Tonga
<OPTION VALUE="TT">Trinidad And Tobago
<OPTION VALUE="TN">Tunisia
<OPTION VALUE="TR">Turkey
<OPTION VALUE="TM">Turkmenistan
<OPTION VALUE="TC">Turks And Caicos Islands
<OPTION VALUE="TV">Tuvalu
<OPTION VALUE="UG">Uganda
<OPTION VALUE="UA">Ukraine
<OPTION VALUE="AE">United Arab Emirates
<OPTION VALUE="GB">United Kingdom/Great Britain
<OPTION VALUE="US" SELECTED>United States
<OPTION VALUE="UM">United States Minor Outlying Islands
<OPTION VALUE="UY">Uruguay
<OPTION VALUE="UZ">Uzbekistan
<OPTION VALUE="VU">Vanuatu
<OPTION VALUE="VA">Vatican City State
<OPTION VALUE="VE">Venezuela
<OPTION VALUE="VN">Viet Nam
<OPTION VALUE="VG">Virgin Islands (British)
<OPTION VALUE="VI">Virgin Islands (U.S.)
<OPTION VALUE="WF">Wallis And Futuna Islands
<OPTION VALUE="EH">Western Sahara
<OPTION VALUE="YE">Yemen
<OPTION VALUE="ZR">Zaire
<OPTION VALUE="ZM">Zambia
<OPTION VALUE="ZW">Zimbabwe
<OPTION VALUE="ZZ">Other-Not Shown</OPTION>
</SELECT></P>
</TD>
</TR>
<TR>
<TD WIDTH=7></TD>
<TD WIDTH=253>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none"><A NAME="bziptitle"></A>
<FONT COLOR="#26268a"><FONT FACE="Arial"><FONT SIZE=2>Zip/Postal
Code:</FONT></FONT></FONT></P>
</TD>
<TD COLSPAN=6 WIDTH=304>
<P><INPUT TYPE=TEXT NAME="bzip" SIZE=10 MAXLENGTH=20></P>
</TD>
</TR>
<TR>
<TD WIDTH=7></TD>
<TD WIDTH=253>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none"><A NAME="phonetitle"></A>
<FONT COLOR="#208a6b"><FONT FACE="Arial"><FONT SIZE=2>Phone:</FONT></FONT></FONT></P>
</TD>
<TD COLSPAN=6 WIDTH=304>
<P><INPUT TYPE=TEXT NAME="phone" SIZE=36 MAXLENGTH=45></P>
</TD>
</TR>
<TR>
<TD WIDTH=7></TD>
<TD WIDTH=253>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none"><A NAME="faxtitle"></A>
<FONT COLOR="#208a6b"><FONT FACE="Arial"><FONT SIZE=2>Fax:</FONT></FONT></FONT></P>
</TD>
<TD COLSPAN=6 WIDTH=304>
<P><INPUT TYPE=TEXT NAME="fax" SIZE=36 MAXLENGTH=45></P>
</TD>
</TR>
<TR>
<TD WIDTH=7></TD>
<TD WIDTH=253>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none"><A NAME="emailtitle"></A>
<FONT COLOR="#208a6b"><FONT FACE="Arial"><FONT SIZE=2>Email:</FONT></FONT></FONT></P>
</TD>
<TD COLSPAN=6 WIDTH=304>
<P><INPUT TYPE=TEXT NAME="email" SIZE=36 MAXLENGTH=45></P>
</TD>
</TR>
</TABLE>
</CENTER>
</DIV>
<CENTER>
<TABLE WIDTH=576 BORDER=0 CELLPADDING=2 CELLSPACING=2>
<TR>
<TD BGCOLOR="#336699">
<P><A NAME="saddtitle"></A><SPAN STYLE="background: #336699"><FONT COLOR="#ffffff"><A HREF="#" ONCLICK="javascript:expandSection(6); return(false);"><IMG SRC="../../../../lpc/docs/images/arrowover.gif" NAME="saddimg" ALIGN=BOTTOM WIDTH=75 HEIGHT=38 BORDER=0></A><A HREF="#" ONCLICK="javascript:expandSection(6); return(false);"><B><SPAN STYLE="font-style: normal"><FONT SIZE=1 STYLE="font-size: 8pt"><FONT FACE="Arial">Shipping</FONT></FONT></SPAN></B></A></FONT></SPAN></P>
</TD>
</TR>
</TABLE>
</CENTER>
<DIV ID="saddChild" DIR="LTR">
<CENTER>
<TABLE WIDTH=576 BORDER=0 CELLPADDING=2 CELLSPACING=0>
<COL WIDTH=7>
<COL WIDTH=253>
<COL WIDTH=0>
<COL WIDTH=58>
<COL WIDTH=0>
<COL WIDTH=62>
<COL WIDTH=164>
<COL WIDTH=0>
<TR>
<TD WIDTH=7></TD>
<TD WIDTH=253>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none">
<FONT COLOR="#208a6b"><FONT FACE="Arial"><FONT SIZE=2>Copy
billing address?</FONT></FONT></FONT></P>
</TD>
<TD COLSPAN=6 WIDTH=304>
<P STYLE="text-decoration: none"><FONT COLOR="#212c47"><INPUT TYPE=CHECKBOX NAME="copy" VALUE="checkbox" ONCLICK="javascript:ShipToBillPerson(this.form);"><SPAN STYLE="font-weight: medium"><SPAN STYLE="font-style: normal"><FONT SIZE=2 STYLE="font-size: 9pt"><FONT FACE="Arial">Yes</FONT></FONT></SPAN></SPAN></FONT></P>
</TD>
</TR>
<TR>
<TD WIDTH=7></TD>
<TD WIDTH=253>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none"><A NAME="shiptypetitle"></A>
<FONT COLOR="#208a6b"><FONT FACE="Arial"><FONT SIZE=2>Shipping
Type:</FONT></FONT></FONT></P>
</TD>
<TD COLSPAN=6 WIDTH=304>
<P><INPUT TYPE=TEXT NAME="shiptype" SIZE=36 MAXLENGTH=36></P>
</TD>
</TR>
<TR>
<TD WIDTH=7></TD>
<TD WIDTH=253>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none"><A NAME="snametitle"></A>
<FONT COLOR="#208a6b"><FONT FACE="Arial"><FONT SIZE=2>Ship to
this person:</FONT></FONT></FONT></P>
</TD>
<TD COLSPAN=6 WIDTH=304>
<P><INPUT TYPE=TEXT NAME="sname" SIZE=36 MAXLENGTH=36></P>
</TD>
</TR>
<TR>
<TD WIDTH=7></TD>
<TD WIDTH=253>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none"><A NAME="saddr1title"></A>
<FONT COLOR="#208a6b"><FONT FACE="Arial"><FONT SIZE=2>Shipping
street address:</FONT></FONT></FONT></P>
</TD>
<TD COLSPAN=6 WIDTH=304>
<P><INPUT TYPE=TEXT NAME="saddr1" SIZE=36 MAXLENGTH=36></P>
</TD>
</TR>
<TR>
<TD WIDTH=7></TD>
<TD WIDTH=253></TD>
<TD COLSPAN=6 WIDTH=304>
<P><INPUT TYPE=TEXT NAME="saddr2" SIZE=36 MAXLENGTH=36></P>
</TD>
</TR>
<TR>
<TD WIDTH=7></TD>
<TD WIDTH=253>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none"><A NAME="scitytitle"></A>
<FONT COLOR="#208a6b"><FONT FACE="Arial"><FONT SIZE=2>City:</FONT></FONT></FONT></P>
</TD>
<TD COLSPAN=6 WIDTH=304>
<P><INPUT TYPE=TEXT NAME="scity" SIZE=36 MAXLENGTH=36></P>
</TD>
</TR>
<TR>
<TD ROWSPAN=2 WIDTH=7></TD>
<TD ROWSPAN=2 WIDTH=253>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none"><A NAME="sstatetitle"></A>
<FONT COLOR="#208a6b"><FONT FACE="Arial"><FONT SIZE=2>State:</FONT></FONT></FONT></P>
</TD>
<TD WIDTH=0 VALIGN=TOP></TD>
<TD WIDTH=58>
<P STYLE="text-decoration: none"><FONT COLOR="#212c47"><SELECT NAME="sstate">
<OPTION VALUE="" SELECTED>...
<OPTION VALUE="AK">AK
<OPTION VALUE="AL">AL
<OPTION VALUE="AR">AR
<OPTION VALUE="AZ">AZ
<OPTION VALUE="CA">CA
<OPTION VALUE="CO">CO
<OPTION VALUE="CT">CT
<OPTION VALUE="DC">DC
<OPTION VALUE="DE">DE
<OPTION VALUE="FL">FL
<OPTION VALUE="GA">GA
<OPTION VALUE="HI">HI
<OPTION VALUE="IA">IA
<OPTION VALUE="ID">ID
<OPTION VALUE="IL">IL
<OPTION VALUE="IN">IN
<OPTION VALUE="KS">KS
<OPTION VALUE="KY">KY
<OPTION VALUE="LA">LA
<OPTION VALUE="MA">MA
<OPTION VALUE="MD">MD
<OPTION VALUE="ME">ME
<OPTION VALUE="MI">MI
<OPTION VALUE="MN">MN
<OPTION VALUE="MO">MO
<OPTION VALUE="MS">MS
<OPTION VALUE="MT">MT
<OPTION VALUE="NC">NC
<OPTION VALUE="ND">ND
<OPTION VALUE="NE">NE
<OPTION VALUE="NH">NH
<OPTION VALUE="NJ">NJ
<OPTION VALUE="NM">NM
<OPTION VALUE="NV">NV
<OPTION VALUE="NY">NY
<OPTION VALUE="OH">OH
<OPTION VALUE="OK">OK
<OPTION VALUE="OR">OR
<OPTION VALUE="PA">PA
<OPTION VALUE="PR">PR
<OPTION VALUE="RI">RI
<OPTION VALUE="SC">SC
<OPTION VALUE="SD">SD
<OPTION VALUE="TN">TN
<OPTION VALUE="TX">TX
<OPTION VALUE="UT">UT
<OPTION VALUE="VA">VA
<OPTION VALUE="VI">VI
<OPTION VALUE="VT">VT
<OPTION VALUE="WA">WA
<OPTION VALUE="WI">WI
<OPTION VALUE="WV">WV
<OPTION VALUE="WY">WY</OPTION>
</SELECT></FONT></P>
</TD>
<TD WIDTH=0></TD>
<TD WIDTH=62>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none">
<FONT COLOR="#208a6b"><FONT FACE="Arial"><FONT SIZE=2>or
Province:</FONT></FONT></FONT></P>
</TD>
<TD WIDTH=164>
<P><INPUT TYPE=TEXT NAME="sstate2" SIZE=20 MAXLENGTH=30 ONCHANGE="javascript:blankstate(this);"></P>
</TD>
<TD WIDTH=0 VALIGN=TOP></TD>
</TR>
<TR>
<TD COLSPAN=6 WIDTH=304></TD>
</TR>
<TR>
<TD WIDTH=7></TD>
<TD WIDTH=253>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none"><A NAME="scountrytitle"></A>
<FONT COLOR="#208a6b"><FONT FACE="Arial"><FONT SIZE=2>Country:</FONT></FONT></FONT></P>
</TD>
<TD COLSPAN=6 WIDTH=304>
<P><SELECT NAME="scountry" ONCHANGE="javascript:blankstate(this);">
<OPTION VALUE="">...
<OPTION VALUE="AF">Afghanistan
<OPTION VALUE="AL">Albania
<OPTION VALUE="DZ">Algeria
<OPTION VALUE="AS">American Samoa
<OPTION VALUE="AD">Andorra
<OPTION VALUE="AO">Angola
<OPTION VALUE="AI">Anguilla
<OPTION VALUE="AQ">Antarctica
<OPTION VALUE="AG">Antigua And Barbuda
<OPTION VALUE="AR">Argentina
<OPTION VALUE="AM">Armenia
<OPTION VALUE="AW">Aruba
<OPTION VALUE="AU">Australia
<OPTION VALUE="AT">Austria
<OPTION VALUE="AZ">Azerbaijan
<OPTION VALUE="BS">Bahamas
<OPTION VALUE="BH">Bahrain
<OPTION VALUE="BD">Bangladesh
<OPTION VALUE="BB">Barbados
<OPTION VALUE="BY">Belarus
<OPTION VALUE="BE">Belgium
<OPTION VALUE="BZ">Belize
<OPTION VALUE="BJ">Benin
<OPTION VALUE="BM">Bermuda
<OPTION VALUE="BT">Bhutan
<OPTION VALUE="BO">Bolivia
<OPTION VALUE="BA">Bosnia And Herzegowina
<OPTION VALUE="BW">Botswana
<OPTION VALUE="BV">Bouvet Island
<OPTION VALUE="BR">Brazil
<OPTION VALUE="IO">British Indian Ocean Territory
<OPTION VALUE="BN">Brunei Darussalam
<OPTION VALUE="BG">Bulgaria
<OPTION VALUE="BF">Burkina Faso
<OPTION VALUE="BI">Burundi
<OPTION VALUE="KH">Cambodia
<OPTION VALUE="CM">Cameroon
<OPTION VALUE="CA">Canada
<OPTION VALUE="CV">Cape Verde
<OPTION VALUE="KY">Cayman Islands
<OPTION VALUE="CF">Central African Republic
<OPTION VALUE="TD">Chad
<OPTION VALUE="CL">Chile
<OPTION VALUE="CN">China
<OPTION VALUE="CX">Christmas Island
<OPTION VALUE="CC">Cocos (Keeling) Islands
<OPTION VALUE="CO">Colombia
<OPTION VALUE="KM">Comoros
<OPTION VALUE="CG">Congo
<OPTION VALUE="CK">Cook Islands
<OPTION VALUE="CR">Costa Rica
<OPTION VALUE="CI">Cote D'Ivoire
<OPTION VALUE="HR">Croatia
<OPTION VALUE="CU">Cuba
<OPTION VALUE="CY">Cyprus
<OPTION VALUE="CZ">Czech Republic
<OPTION VALUE="DK">Denmark
<OPTION VALUE="DJ">Djibouti
<OPTION VALUE="DM">Dominica
<OPTION VALUE="DO">Dominican Republic
<OPTION VALUE="TP">East Timor
<OPTION VALUE="EC">Ecuador
<OPTION VALUE="EG">Egypt
<OPTION VALUE="SV">El Salvador
<OPTION VALUE="GQ">Equatorial Guinea
<OPTION VALUE="ER">Eritrea
<OPTION VALUE="EE">Estonia
<OPTION VALUE="ET">Ethiopia
<OPTION VALUE="FK">Falkland Islands
<OPTION VALUE="FO">Faroe Islands
<OPTION VALUE="FJ">Fiji
<OPTION VALUE="FI">Finland
<OPTION VALUE="FR">France
<OPTION VALUE="FX">France, Metropolitan
<OPTION VALUE="GF">French Guiana
<OPTION VALUE="PF">French Polynesia
<OPTION VALUE="TF">French Southern Territories
<OPTION VALUE="GA">Gabon
<OPTION VALUE="GM">Gambia
<OPTION VALUE="GE">Georgia
<OPTION VALUE="DE">Germany
<OPTION VALUE="GH">Ghana
<OPTION VALUE="GI">Gibraltar
<OPTION VALUE="GR">Greece
<OPTION VALUE="GL">Greenland
<OPTION VALUE="GD">Grenada
<OPTION VALUE="GP">Guadeloupe
<OPTION VALUE="GU">Guam
<OPTION VALUE="GT">Guatemala
<OPTION VALUE="GN">Guinea
<OPTION VALUE="GW">Guinea-Bissau
<OPTION VALUE="GY">Guyana
<OPTION VALUE="HT">Haiti
<OPTION VALUE="HM">Heard And Mc Donald Islands
<OPTION VALUE="HN">Honduras
<OPTION VALUE="HK">Hong Kong
<OPTION VALUE="HU">Hungary
<OPTION VALUE="IS">Iceland
<OPTION VALUE="IN">India
<OPTION VALUE="ID">Indonesia
<OPTION VALUE="IR">Iran
<OPTION VALUE="IQ">Iraq
<OPTION VALUE="IE">Ireland
<OPTION VALUE="IL">Israel
<OPTION VALUE="IT">Italy
<OPTION VALUE="JM">Jamaica
<OPTION VALUE="JP">Japan
<OPTION VALUE="JO">Jordan
<OPTION VALUE="KZ">Kazakhstan
<OPTION VALUE="KE">Kenya
<OPTION VALUE="KI">Kiribati
<OPTION VALUE="KP">North Korea
<OPTION VALUE="KR">South Korea
<OPTION VALUE="KW">Kuwait
<OPTION VALUE="KG">Kyrgyzstan
<OPTION VALUE="LA">Lao People's Republic
<OPTION VALUE="LV">Latvia
<OPTION VALUE="LB">Lebanon
<OPTION VALUE="LS">Lesotho
<OPTION VALUE="LR">Liberia
<OPTION VALUE="LY">Libyan Arab Jamahiriya
<OPTION VALUE="LI">Liechtenstein
<OPTION VALUE="LT">Lithuania
<OPTION VALUE="LU">Luxembourg
<OPTION VALUE="MO">Macau
<OPTION VALUE="MK">Macedonia
<OPTION VALUE="MG">Madagascar
<OPTION VALUE="MW">Malawi
<OPTION VALUE="MY">Malaysia
<OPTION VALUE="MV">Maldives
<OPTION VALUE="ML">Mali
<OPTION VALUE="MT">Malta
<OPTION VALUE="MH">Marshall Islands
<OPTION VALUE="MQ">Martinique
<OPTION VALUE="MR">Mauritania
<OPTION VALUE="MU">Mauritius
<OPTION VALUE="YT">Mayotte
<OPTION VALUE="MX">Mexico
<OPTION VALUE="FM">Micronesia
<OPTION VALUE="MD">Moldova
<OPTION VALUE="MC">Monaco
<OPTION VALUE="MN">Mongolia
<OPTION VALUE="MS">Montserrat
<OPTION VALUE="MA">Morocco
<OPTION VALUE="MZ">Mozambique
<OPTION VALUE="MM">Myanmar
<OPTION VALUE="NA">Namibia
<OPTION VALUE="NR">Nauru
<OPTION VALUE="NP">Nepal
<OPTION VALUE="NL">Netherlands
<OPTION VALUE="AN">Netherlands Antilles
<OPTION VALUE="NC">New Caledonia
<OPTION VALUE="NZ">New Zealand
<OPTION VALUE="NI">Nicaragua
<OPTION VALUE="NE">Niger
<OPTION VALUE="NG">Nigeria
<OPTION VALUE="NU">Niue
<OPTION VALUE="NF">Norfolk Island
<OPTION VALUE="MP">Northern Mariana Islands
<OPTION VALUE="NO">Norway
<OPTION VALUE="OM">Oman
<OPTION VALUE="PK">Pakistan
<OPTION VALUE="PW">Palau
<OPTION VALUE="PA">Panama
<OPTION VALUE="PG">Papua New Guinea
<OPTION VALUE="PY">Paraguay
<OPTION VALUE="PE">Peru
<OPTION VALUE="PH">Philippines
<OPTION VALUE="PN">Pitcairn
<OPTION VALUE="PL">Poland
<OPTION VALUE="PT">Portugal
<OPTION VALUE="PR">Puerto Rico
<OPTION VALUE="QA">Qatar
<OPTION VALUE="RE">Reunion
<OPTION VALUE="RO">Romania
<OPTION VALUE="RU">Russian Federation
<OPTION VALUE="RW">Rwanda
<OPTION VALUE="KN">Saint Kitts And Nevis
<OPTION VALUE="LC">Saint Lucia
<OPTION VALUE="VC">Saint Vincent And The Grenadines
<OPTION VALUE="WS">Samoa
<OPTION VALUE="SM">San Marino
<OPTION VALUE="ST">Sao Tome And Principe
<OPTION VALUE="SA">Saudi Arabia
<OPTION VALUE="SN">Senegal
<OPTION VALUE="SC">Seychelles
<OPTION VALUE="SL">Sierra Leone
<OPTION VALUE="SG">Singapore
<OPTION VALUE="SK">Slovakia
<OPTION VALUE="SI">Slovenia
<OPTION VALUE="SB">Solomon Islands
<OPTION VALUE="SO">Somalia
<OPTION VALUE="ZA">South Africa
<OPTION VALUE="GS">South Georgia & South Sandwich Islands
<OPTION VALUE="ES">Spain
<OPTION VALUE="LK">Sri Lanka
<OPTION VALUE="SH">St Helena
<OPTION VALUE="PM">St Pierre and Miquelon
<OPTION VALUE="SD">Sudan
<OPTION VALUE="SR">Suriname
<OPTION VALUE="SJ">Svalbard And Jan Mayen Islands
<OPTION VALUE="SZ">Swaziland
<OPTION VALUE="SE">Sweden
<OPTION VALUE="CH">Switzerland
<OPTION VALUE="SY">Syrian Arab Republic
<OPTION VALUE="TW">Taiwan
<OPTION VALUE="TJ">Tajikistan
<OPTION VALUE="TZ">Tanzania
<OPTION VALUE="TH">Thailand
<OPTION VALUE="TG">Togo
<OPTION VALUE="TK">Tokelau
<OPTION VALUE="TO">Tonga
<OPTION VALUE="TT">Trinidad And Tobago
<OPTION VALUE="TN">Tunisia
<OPTION VALUE="TR">Turkey
<OPTION VALUE="TM">Turkmenistan
<OPTION VALUE="TC">Turks And Caicos Islands
<OPTION VALUE="TV">Tuvalu
<OPTION VALUE="UG">Uganda
<OPTION VALUE="UA">Ukraine
<OPTION VALUE="AE">United Arab Emirates
<OPTION VALUE="GB">United Kingdom/Great Britain
<OPTION VALUE="US" SELECTED>United States
<OPTION VALUE="UM">United States Minor Outlying Islands
<OPTION VALUE="UY">Uruguay
<OPTION VALUE="UZ">Uzbekistan
<OPTION VALUE="VU">Vanuatu
<OPTION VALUE="VA">Vatican City State
<OPTION VALUE="VE">Venezuela
<OPTION VALUE="VN">Viet Nam
<OPTION VALUE="VG">Virgin Islands (British)
<OPTION VALUE="VI">Virgin Islands (U.S.)
<OPTION VALUE="WF">Wallis And Futuna Islands
<OPTION VALUE="EH">Western Sahara
<OPTION VALUE="YE">Yemen
<OPTION VALUE="ZR">Zaire
<OPTION VALUE="ZM">Zambia
<OPTION VALUE="ZW">Zimbabwe
<OPTION VALUE="ZZ">Other-Not Shown</OPTION>
</SELECT></P>
</TD>
</TR>
<TR>
<TD WIDTH=7></TD>
<TD WIDTH=253>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none"><A NAME="sziptitle"></A>
<FONT COLOR="#208a6b"><FONT FACE="Arial"><FONT SIZE=2>Zip/Postal
Code:</FONT></FONT></FONT></P>
</TD>
<TD COLSPAN=6 WIDTH=304>
<P><INPUT TYPE=TEXT NAME="szip" SIZE=10 MAXLENGTH=20></P>
</TD>
</TR>
</TABLE>
</CENTER>
</DIV>
<CENTER>
<TABLE WIDTH=576 BORDER=0 CELLPADDING=2 CELLSPACING=2>
<TR>
<TD COLSPAN=3 BGCOLOR="#336699">
<P><SPAN STYLE="background: #336699"><FONT COLOR="#ffffff"><A HREF="#" ONCLICK="javascript:expandPB(); return(false);"><IMG SRC="../../../../lpc/docs/images/arrowover.gif" NAME="pbimg" ALIGN=BOTTOM WIDTH=75 HEIGHT=38 BORDER=0></A><A HREF="#" ONCLICK="javascript:expandPB(); return(false);"><B><SPAN STYLE="font-style: normal"><FONT SIZE=1 STYLE="font-size: 8pt"><FONT FACE="Arial">Make
recurring (for Credit Card Sale Transactions ONLY)</FONT></FONT></SPAN></B></A></FONT></SPAN></P>
</TD>
</TR>
</TABLE>
</CENTER>
<DIV ID="pbChild" DIR="LTR">
<CENTER>
<TABLE WIDTH=576 BORDER=0 CELLPADDING=2 CELLSPACING=2>
<TR>
<TD WIDTH=8></TD>
<TD WIDTH=251>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none">
<FONT COLOR="#26268a"><FONT FACE="Arial"><FONT SIZE=2>Make
recurring?</FONT></FONT></FONT></P>
</TD>
<TD>
<P STYLE="text-decoration: none"><FONT COLOR="#212c47"><INPUT TYPE=CHECKBOX NAME="makerecurring" VALUE="1"><SPAN STYLE="font-weight: medium"><SPAN STYLE="font-style: normal"><FONT SIZE=2 STYLE="font-size: 9pt"><FONT FACE="Arial">Yes
</FONT></FONT></SPAN></SPAN></FONT>
</P>
</TD>
</TR>
<TR>
<TD WIDTH=8></TD>
<TD>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none">
<FONT COLOR="#26268a"><FONT FACE="Arial"><FONT SIZE=2>Bill the
customer: </FONT></FONT></FONT>
</P>
</TD>
<TD>
<P><SPAN STYLE="text-decoration: none"><SPAN STYLE="font-weight: medium"><SPAN STYLE="font-style: normal"><FONT SIZE=2 STYLE="font-size: 9pt"><FONT FACE="Arial"><FONT COLOR="#212c47">every
</FONT></FONT></FONT></SPAN></SPAN></SPAN><INPUT TYPE=TEXT NAME="periodicity_num" SIZE=3 MAXLENGTH=3><SELECT NAME="periodicity_type" STYLE="color: #26268a; font-family: 'Arial'; font-size: 10pt">
<OPTION VALUE="" SELECTED>...
<OPTION VALUE="d">Day(s)
<OPTION VALUE="w">Week(s)
<OPTION VALUE="m">Month(s)
<OPTION VALUE="y">Year(s)</OPTION>
</SELECT></P>
</TD>
</TR>
<TR>
<TD WIDTH=8></TD>
<TD>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none">
<FONT COLOR="#26268a"><FONT FACE="Arial"><FONT SIZE=2>Start on:</FONT></FONT></FONT></P>
</TD>
<TD>
<P STYLE="text-decoration: none"><FONT COLOR="#212c47"><SELECT NAME="startmonth">
<OPTION VALUE="01" SELECTED>01
<OPTION VALUE="02">02
<OPTION VALUE="03">03
<OPTION VALUE="04">04
<OPTION VALUE="05">05
<OPTION VALUE="06">06
<OPTION VALUE="07">07
<OPTION VALUE="08">08
<OPTION VALUE="09">09
<OPTION VALUE="10">10
<OPTION VALUE="11">11
<OPTION VALUE="12">12</OPTION>
</SELECT> <SPAN STYLE="font-weight: medium"><SPAN STYLE="font-style: normal"><FONT SIZE=2 STYLE="font-size: 9pt"><FONT FACE="Arial">/
<SELECT NAME="startday">
<OPTION VALUE="01" SELECTED>01
<OPTION VALUE="02">02
<OPTION VALUE="03">03
<OPTION VALUE="04">04
<OPTION VALUE="05">05
<OPTION VALUE="06">06
<OPTION VALUE="07">07
<OPTION VALUE="08">08
<OPTION VALUE="09">09
<OPTION VALUE="10">10
<OPTION VALUE="11">11
<OPTION VALUE="12">12
<OPTION VALUE="13">13
<OPTION VALUE="14">14
<OPTION VALUE="15">15
<OPTION VALUE="16">16
<OPTION VALUE="17">17
<OPTION VALUE="18">18
<OPTION VALUE="19">19
<OPTION VALUE="20">20
<OPTION VALUE="21">21
<OPTION VALUE="22">22
<OPTION VALUE="23">23
<OPTION VALUE="24">24
<OPTION VALUE="25">25
<OPTION VALUE="26">26
<OPTION VALUE="27">27
<OPTION VALUE="28">28
<OPTION VALUE="29">29
<OPTION VALUE="30">30
<OPTION VALUE="31">31</OPTION>
</SELECT> /
<SELECT NAME="startyear">
<OPTION VALUE="2005" SELECTED>2005
<OPTION VALUE="2006">2006
<OPTION VALUE="2007">2007
<OPTION VALUE="2008">2008
<OPTION VALUE="2009">2009
<OPTION VALUE="2010">2010
<OPTION VALUE="2011">2011
<OPTION VALUE="2012">2012</OPTION>
</SELECT></FONT></FONT></SPAN></SPAN></FONT></P>
</TD>
</TR>
<TR>
<TD WIDTH=8></TD>
<TD>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none">
<FONT COLOR="#26268a"><FONT FACE="Arial"><FONT SIZE=2>End
after:</FONT></FONT></FONT></P>
</TD>
<TD>
<P><INPUT TYPE=TEXT NAME="installments" SIZE=3 MAXLENGTH=3><SPAN STYLE="text-decoration: none"><SPAN STYLE="font-weight: medium"><SPAN STYLE="font-style: normal"><FONT SIZE=2 STYLE="font-size: 9pt"><FONT FACE="Arial"><FONT COLOR="#212c47">payments
</FONT></FONT></FONT></SPAN></SPAN></SPAN>
</P>
</TD>
</TR>
<TR>
<TD WIDTH=8></TD>
<TD>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none">
<FONT COLOR="#26268a"><FONT FACE="Arial"><FONT SIZE=2>Retry
transaction</FONT></FONT></FONT></P>
</TD>
<TD>
<P><INPUT TYPE=TEXT NAME="threshold" SIZE=3 MAXLENGTH=1><SPAN STYLE="text-decoration: none"><SPAN STYLE="font-weight: medium"><SPAN STYLE="font-style: normal"><FONT SIZE=2 STYLE="font-size: 9pt"><FONT FACE="Arial"><FONT COLOR="#212c47">times
(if the transaction fails) before notifying me.</FONT></FONT></FONT></SPAN></SPAN></SPAN></P>
</TD>
</TR>
</TABLE>
</CENTER>
</DIV>
<DIV ID="nopbChild" DIR="LTR">
<CENTER>
<TABLE WIDTH=576 BORDER=0 CELLPADDING=2 CELLSPACING=2>
<TR>
<TD>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none">
<FONT COLOR="#212c47"><FONT FACE="Arial"><FONT SIZE=2 STYLE="font-size: 9pt">The
transaction type you are using cannot be recurring. The only
transaction type which can be recurring is a Credit Card Sale.
If you need to make your transaction recurring, please select
Transaction Type Sale in the Pay by Credit Card section.</FONT></FONT></FONT></P>
</TD>
</TR>
</TABLE>
</CENTER>
</DIV>
<CENTER>
<TABLE WIDTH=576 BORDER=0 CELLPADDING=2 CELLSPACING=2>
<TR>
<TD COLSPAN=3 BGCOLOR="#336699">
<P><SPAN STYLE="background: #336699"><FONT COLOR="#ffffff"><A HREF="#" ONCLICK="javascript:expandSection(8); return(false);"><IMG SRC="../../../../lpc/docs/images/arrowover.gif" NAME="cmtimg" ALIGN=BOTTOM WIDTH=75 HEIGHT=38 BORDER=0></A><A HREF="#" ONCLICK="javascript:expandSection(8); return(false);"><B><SPAN STYLE="font-style: normal"><FONT SIZE=1 STYLE="font-size: 8pt"><FONT FACE="Arial">Comments</FONT></FONT></SPAN></B></A></FONT></SPAN></P>
</TD>
</TR>
</TABLE>
</CENTER>
<DIV ID="cmtChild" DIR="LTR">
<CENTER>
<TABLE WIDTH=576 BORDER=0 CELLPADDING=2 CELLSPACING=2>
<TR>
<TD WIDTH=8 VALIGN=TOP></TD>
<TD WIDTH=251 VALIGN=TOP>
<P STYLE="font-style: normal; font-weight: medium; text-decoration: none">
<FONT COLOR="#208a6b"><FONT FACE="Arial"><FONT SIZE=2>Comments:
</FONT></FONT></FONT>
</P>
</TD>
<TD>
<P><TEXTAREA NAME="comments" ROWS=5 COLS=34 WRAP=SOFT STYLE="color: #000080; font-family: 'Arial'; background: #dfe1e4" SDEVENT--="storeSelection(this)"></TEXTAREA><INPUT TYPE=HIDDEN NAME="referred"></P>
</TD>
</TR>
</TABLE>
</CENTER>
</DIV>
<CENTER>
<TABLE WIDTH=576 BORDER=0 CELLPADDING=2 CELLSPACING=2>
<TR>
<TD COLSPAN=3 BGCOLOR="#336699">
<DIV ALIGN=RIGHT>
<P><FONT COLOR="#ffffff"><INPUT TYPE=BUTTON NAME="submitbt" VALUE="-- Continue --" ONCLICK="javascript:setsubmitdata();"><INPUT TYPE=BUTTON VALUE="-- Clear Form --" ONCLICK="javascript:onReset();"></FONT></P>
</DIV>
</TD>
</TR>
<TR>
<TD COLSPAN=3>
<P><BR>
</P>
</TD>
</TR>
</TABLE>
</CENTER>
</FORM>
<P CLASS="copyright" ALIGN=CENTER>©2004, LinkPoint
International. All rights reserved. <A HREF="../../../../lpc/docs/privacypolicy.html" TARGET="content"><U><FONT COLOR="#212c47">Privacy
Policy</FONT></U></A></P>
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