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IRA Analyzer ORDER FORM


To order, Please complete the order form below and either

  • use your browser to print the form and mail it along with a check or money order to:

    Larry J. Kasper, CPA
    4267 Shire Cove Road
    Hilliard, Ohio 43026,       or

  • e-mail your order by clicking the "Submit  Form" button at the end of the form.

Your order will be sent by first class mail.

Note: Credit card orders will be shipped only to the credit card billing address.

To Delete an entry, simply backspace.  To Erase ALL entries, click the "Reset Form" button at the bottom of the form.  Do NOT hit ENTER unless you are finished and intend to submit the form.  Use the mouse, tab, or arrow keys to move between fields.

First name
Last name
Title (Optional)
Organization (Optional)
Street address
Address (cont.)
City
State/Province
Zip/Postal code
Country (if not USA)

Please enter a number(s) in case there is a problem with your order.

Work Phone
Home Phone
FAX
E-mail (Helpful)
Product
Price
Total
Amount

IRA Analyzer Excel file on floppy disk.
(IBM format only, cannot be converted to any other format)

$ 20.00

$ 20.00

Shipping and Handling ($ 5.00 per order)

$ 5.00

TOTAL  Order Amount Paid

$ 25.00


Please provide the following additional information, if ordering by credit card:

BILLING

Credit card

Cardholder name
Card number
Expiration date

NOTE: Credit card orders will only be shipped to the verified credit card address above.

If you just want to print the form without submitting for electronic processing, use your browser's Print button.