Personal Historian Order Form

Instructions :	Mail this form and payment to: RootsMagic, Inc. PO Box 495 Springville, UT 84663 USA
Print this order form. Calculate the order total including shipping and sales tax (if applicable). Fill out each line legibly. If ordering by credit card, please double check the credit card number, expiration date, and your signature. If not playing by credit card, be sure to include your payment with this form.

Description	Price	Quantity	Total
Personal Historian 1.1 Software CD	$29.95
Shipping *
Utah Residents include 6.5% Sales Tax **
Order Total
* Shipping is $5 for the first item and $3 for each additional item. Orders outside of North America should add $5. ** Sales tax is approximately $2.27 for the first item and $2.14 for each additional item.

Bill To (If paying by credit card, this should be the address of the person whose name appears on the card.)
Name :
Address :
City :		State / Province / County :		ZIP / Postal Code :
Country :		Phone :
E-Mail :

Ship To (If different than the "Bill To" address; Where do you want the software sent?)
Name :
Address :
City :		State / Province / County :		ZIP / Postal Code :
Country :		Phone :
E-Mail :