REGISTRATION & INVOICE

Note that the Quicrypt 1.10 software has been delivered and accepted
by the customer.  Upon receipt of this paid invoice, the printed 
documentation and disks paid for will be sent.

Remit to:                       Ship to:

Mike Johnson                    ________________________________

PO Box 1151                     ________________________________

Longmont CO 80502-1151          ________________________________

USA                             ________________________________

                                                Contact person:

                                ________________________________

                                ________________________________

Quantity   Description                             Unit Price  Total

________   Quicrypt registration with disk & manual.   $49.00  ______

________   Quicrypt single copy registration only.     $20.00  ______

________   Site license for unlimited use of Quicrypt
           at one corporation (includes one disk &
	   one manual).                               $295.00  ______

           Sales tax (if you are in Colorado)                  ______

           Shipping and handling if a disk and manual
           has been ordered.                            $5.00  ______

                                                      Total    ______

Please check all that apply to you (and only those that apply to 
you) so that I can determine if I can legally send you the pass 
phrase to unlock the full strength registered version 
(QCRYPT.EXE), or if you have to be content with the shareware 
version (but registered).  I also need to know the size of disks 
you prefer to use.

__ I am a citizen of the United States of America or Canada.
__ I am not a citizen of the USA, but I am a permanent resident 
   (with a "green card").
__ I promise not to export QCRYPT.EXE or the password that unlocks 
   it without proper legal authority and without registering every 
   copy in use.
__ I promise not to give QCRYPT.EXE or the password that unlocks it 
   to anyone who would export it without legal authority or use it 
   without registering it.
__ I prefer 3.5" disks.
__ I prefer 5.25" disks.


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Signature                                        Date                           


