dataComet Order Form

databeast, Inc.
1668 Trumansburg Rd.
Ithaca, NY 14850-9213
Fax: 607-277-5808
E-mail:

IRS Form W9 Information:
Our U.S. Federal Tax ID is 16-1470153. databeast, Inc. is a small business that is neither minority-owned nor female-owned, according to U.S. Federal and State definitions of these categories.

Purchaser:

Purchaser E-mail:

Organization:

Mailing Address:

City:

State:

Zip Code:

Phone:

Local Support Contact:

Product (circle one):

dataComet X
dataComet-Secure
dataComet Classic

Number of licenses:

Price/copy:

Total:

Payment: (circle one)

Visa MasterCard American Express
Purchase Order Check Money Order

Credit Card #:

Expiration Date (MM/YY):

PO#:

Site licensees:

Please list your local technical support contact information in the Local Support Contact field. This info will be displayed in the dataComet splash screen and About box.

Something in the form of the following would be appropriate:

For support, call Brighton Computer Services at x-3022 or send 
mail to support@brighton.zip

The registration code for dataComet Site Licensees will be e-mailed to the Support Contact for the Site, who will also receive email notifications when new versions of dataComet become available. Specifying a Local Support Contact is optional, but it can remind your users how to reach your local support contact when they need help using your hosts.