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GO-LOTTO V4.xx REGISTRATION $29.95 USD

NAME________________________________________________

ADDRESS_____________________________________________

ADDRESS_____________________________________________

CREDIT CARD #_______________________________________

Visa,MC,Discover, or American Express

3 DIGIT SECURITY CODE______________________________

EXPIRE DATE_________________________________________

TELEPHONE #_________________________________________

SIGNATURE ___________________________________________

For quicker registration and no shipping and handling charge,
also add E-MAIL address and registration number will be
sent by E-MAIL to you.

E-MAIL ADDRESS ____________________________________________

Make check or money order payable to O'Falls Software
(allow 3-4 weeks for Delivery on Personal Checks).

O'FALLS SOFTWARE
631 OLD PLANTATION ROAD
JEKYLL ISLAND GA 31527