Warranty Registration

Licensing Client:________________________________________________________________

Address:_______________________________________________________________________

Tel/Fax:________________________________________________________________________

Client Representative/Title:________________________________________________________

Date & Place of Acquisition:_______________________________________________________

From Whom Acquired:____________________________________________________________

Product(s) Acquired:_____________________________________________________________

_______________________________________________________________________________

Comments:_____________________________________________________________________

_______________________________________________________________________________

I agree that my rights and obligations in licensing these data have been explained to me and that I will honor them.

To complete registration, a xerographic copy of the receipt of purchase for the licensed data must be attached.

Signature:______________________________________________________________________