From: Subject: Date: Fri, 17 Oct 2008 12:32:19 -0400 MIME-Version: 1.0 Content-Type: text/html; charset="iso-8859-1" Content-Transfer-Encoding: quoted-printable Content-Location: mhtml:file://C:\Documents%20and%20Settings\Danielle%20Wise\Local%20Settings\Temporary%20Internet%20Files\Content.MSO\WordWebPagePreview\6C4B25ED.mht X-MimeOLE: Produced By Microsoft MimeOLE V6.00.2900.3350

The Life Made Easy Company

LME=20 Order Form:

(Please FAX this form to:=20 513-322-7921)

&nbs= p; =20

Your FULL=20 name/Title:

_________________________________________________________________= _______

HOW DID YOU HEAR = ABOUT=20 US?

Search Engine( ) Friend( ) Web( ) Flyer( ) Other( )

Products wanted:=20 (please=20 use price=20 information provided in quote given via=20 fax/e-mail)

(1) PRODUCT = NAME=20 and = #-_____________________________________________

PRICE $ _________________ how many?=20 ____________

(2) PRODUCT = NAME and #-=20 ____________________________________________

PRICE $ _________________ how many?=20 ____________

*Shipping $______________ *Tax $ = __________=20 *Discounts if any $____________

TOTAL=20 DUE=20 (please=20 add shipping & tax=20 above)$$__________________

Your Phone: = include area code=20 ___________________________________________

Your exact = postal=20 address:_____________________________________________

_________________________________________________________________= ____

Your = E-MAIL:=20 ________________________________________________________

Is product going = to an=20 address different from yours?

Yes( ) No( )

If so, what is=20 recipient=92s name? = ___________________________________________=20 (If there are multiple recipients, please type all addresses = on=20 separate sheet of paper and fax with this form or send address-list to = our=20 attention via e-mail.)

Their=20 Address?_____________________________________________________________

Your greeting=20 message:______________________________________________________

-----------------------------------------------------------------= ---------------------------------------------

Method of=20 Payment:=20 Credit Card( ) Check( ) Money Order( )

(make checks = payable to:=20 Life Made Easy) U.S. DOLLARS = ONLY =

Credit Card: = VISA( ) =20 MC( ) AMEX( ) DISC ( ) (LME will use PayPal = to process=20 your credit card)

CARD#:___________________________________=20 Expiration date:_____________

Exact name on card:=20 _____________________________________________________

Billing=20 address of=20 card if different from=20 above:_________________________________

Credit card = 3-digit=20 security code___________(usually located on the back of card, = the=20 last 3 digits at the end of the number series near signature. American Express 4-digit code = on front=20 of card)

Your=20 Signature__________________________________________=20 Date__________

All=20 orders in Ohio=20 must include 6.5% sales tax plus shipping charges

Phone: 513-841-0654 * Fax: 513-322-7921 * email: = sales@LifeMadeEasy.org=20

web:=20 www.LifeMadeEasy.org

***THIS=20 FORM MUST BE COMPLETED IN ITS ENTIRETY IN ORDER TO PROCESS ORDER*** =20