Standard Order Form

WELCOME TO THE DEMO STORE!
THIS IS FOR DEMONSTRATION PURPOSES ONLY. This is a demonstration of the iTransact.com's Standard order form. The customer's name, address, email address, and account information are requested on the merchant's site.

	PRODUCT DESCRIPTION		PRICE

Octane Laptop XL34		$2,275.95
Intel 233 MHz Pentium 4.1GB Hard Drive 4MB Video RAM Internal 20X CD-ROM	64MB EDO RAM TV-Out Port 13.3" TFT/DSTN 16-bit Stereo Sound
Select to Order \| Quantity:

	PRODUCT DESCRIPTION		PRICE

THX Workstation		$2,385.95
Intel Pentium 32MB Sychronous DRAM 3.2GB Hard Drive QWE 3D Grahics Card 2MB SDRAM	17" CRT .28dp Monitor 33.6 Fax Modem 16-bit PCI Sound Card Enhanced Software Collection titles
Select to Order \| CPU Speed: Increase Monitor to 19 inch (Add $300.00) Add 32 MB RAM (64 MB total) (Add $40.00)

	PRODUCT DESCRIPTION		PRICE

Stellar EXC+ Server		$4,102.00
Intel 333 MHz Pentium II Intel Triton 440FX Chipset 9.4GB SCSI Hard Disk 30X IDE CD-ROM 128MB EDO RAM	17" Flat Screen .28NI Monitor 240W Stereo Speakers MS Windows NT/Office 56K Fax/Modem w/Voice 3-Year On-Site Warranty
Select to Order \| Case Color: 56k Sportster Modem (Add $65.00) 400 MHz Processor (Add $249.95)

GENERAL INFORMATION

First Name:	Last Name:
Address:
City:	State: Zip:
Country:
Phone Number:
E-Mail Address:

CREDIT CARD PAYMENT OPTION

Card Number:		Exp. Date:
Demo Number:	5454545454545454	Demo Exp. Date: 12/2020

CHECKING ACCOUNT PAYMENT OPTION

At the bottom of your check is a series of numbers, separated by symbols. It is not necessary to enter symbols or spaces in the fields provided below.

Enter the series of nine numbers
between this symbol   (Demo ABA: 124000054)

Enter the series of numbers
found before this symbol   (Demo ACCT: 12345)

Check number to use:     (Not required.)

Note: Some banks use a non-standard format in this series of numbers. If your account number includes this symbol , simply disregard the symbols and enter this section of numbers.

SUBMIT THIS FORM ONCE ONLY!
This transaction will be processed in REAL-TIME.
Pressing submit multiple times will cause duplicate orders and charges to your account. Your transaction should be completed in 10-25 seconds, depending on Internet traffic. In some cases, it may take longer. If your browser supports JavaScript, a timer will count up from zero. Please be patient.

Are you concerned about using your credit card or check online? iTransact.com uses secure server technology with an authentic digital certificate from Verisign. 100% Safe and Secure.