<![CDATA[
<body background="flagbg.gif" text="#000080" topmargin="0" leftmargin="0">
<hr width="470" color="#000080">
<center>
<table border="0" cellpadding="0" cellspacing="0" width="100%">
<tr><td valign="top" colspan=4>
<p align="center"><font size=+3 color="#ff0000"><b>Order Instructions</b></font><br>
(all searches held in strict confidence)
</td>
<tr><td align="center" colspan=4>
We Accept<p>
</td></tr>
<tr><td align="center">
<img src="images/visa1.gif" border=1></td> <td align="center"><img src="images/Master.gif" border=1></td> <td align="center"><img src="images/Amex.gif" border=1></td> <td align="center"><img src="images/Discover.gif" border=1></td> </tr>
<tr><td colspan=4>
<center><font size=3 color="#00007f"><b>PMB 229<br>1464 Graves Ave. # 107<br> El Cajon, CA 92021</font></center>
<p>
<center><table><tr><td align=center colspan=4>
<b><font size=+1>You May Order Online<br>
(Sorry, we can no longer accept mailed or faxed orders),
</font></a>
</td></tr>
<tr><td colspan=4>
<ul>
<li type=disk>or call 800-854-5352.
</ul><p>
</td></tr></table></center>
<p><center>
<b>Please allow 3-14 days for results.</b></center></p>
<p align="center"><strong>Disclaimer:</strong></p>
<p align="left"><small>Tracing America strives to supply accurate and complete information in a timely manner. Due to computer errors and other factors beyond our control, Tracing America is released of all liability and there is absolutely no warranty, expressed or implied, as to the accuracy, completeness, or availability of the information supplied. Our searches are for informational purposes. They can not be used as exhibits or as evidence. It is the sole responsibility of our clients to obtain verification of any and all information which Tracing America supplies.
<hr color="#000080" noshade size="3" width="85%">
<p align="center"><font color="#0000ff"><b><b><big><big><big>Order Form</big></big></big><br>
</b></b></font><font color="#FF0000"><strong>Required fields are marked with an asterisk</strong></font> *</p>
</blockquote>
<div align=center>
<FORM>
<input type="button" value="A Word About Fraud"
onclick="msgWindow=window.open('http://www.tracingamerica.com/fraudwindow.htm','newwindow','scrollbars=no,width=400,height=250')">
</FORM>
</div>
<form method=post action=/wmpro/wmprodb.exe>
<input name="where" value="www.tracing-america.com" type="hidden">
<input type="HIDDEN" NAME="RECIPIENT" VALUE="searches@tracingamerica.com">
<input type="HIDDEN" NAME="SUBJECT" VALUE="Tracing America Original">
<input type="HIDDEN" NAME="TEMPLATE_MAIL" VALUE="mailtemplate\tracingordsend.tem">
<input type="HIDDEN" NAME="TEMPLATE_WEB" VALUE="mailtemplate\tracingordtemp.tem">
<input type="HIDDEN" NAME="REDIRMISSING" VALUE="/wmpro/Samples/gbMissing.htm">
<input type="HIDDEN" NAME="REQUIRED" VALUE="Name,StreetAddress,City,State,CardType,CardHolderName,CardNumber,CardExpiration,Userinitials,subjCodeNumber">
<INPUT TYPE="HIDDEN" NAME="RECEIPT_SUBJECT" VALUE="Thank you for using Tracing America">
<INPUT TYPE="HIDDEN" NAME="DO_RECEIPT" VALUE="ON">
<INPUT TYPE="HIDDEN" NAME="RECEIPT_FROM" VALUE="searches@tracingamerica.com">
<INPUT TYPE="HIDDEN" NAME="TEMPLATE_RECEIPT" VALUE="mailtemplate\tracingresponse.tem">
<p><center><strong>Please provide the following contact information:</strong><br>
(all information is kept in strict confidence)</center></p>
<blockquote>
<table>
<tr>
<td align="right"><em>Full Name</em></td>
<td><input name="Name" size="25" maxlength="128"> *</td>
</tr>
<tr>
<td align="right"><em>Street address</em></td>
<td><input name="StreetAddress" size="35"> *</td>
</tr>
<tr>
<td align="right"><em>City</em></td>
<td><input name="City" size="35"> *</td>
</tr>
<tr>
<td align="right"><em>State/Province</em></td>
<td><input name="State" size="35"> *</td>
</tr>
<tr>
<td align="right"><em>Zip code</em></td>
<td><input name="ZipCode" size="12" maxlength="12"> </td>
</tr>
<tr>
<td align="right"><em>Country</em></td>
<td><input name="Country" size="25"> </td>
</tr>
<tr>
<td align="right"><em>Home Phone</em></td>
<td><input name="HomePhone" size="25" maxlength="25"> </td>
</tr>
<tr>
<td align="right"><em>FAX</em></td>
<td><input name="FAX" size="25" maxlength="25"> </td>
</tr>
<tr>
<td align="right"><em>Email</em><input type="hidden" name="email" value="order-secure2@tracingamerica.com"></td>
<td><input name="Email" size="25"> </td>
</tr>
</table>
</blockquote>
<p>Please provide the following ordering information:</p>
<blockquote>
<table>
<tr>
<td></td>
<td><strong>BILLING</strong></td>
</tr>
<tr>
<td><em>Credit card</em></td>
<td><select name="CardType" size="1">
<option selected value="Choose Your Card!">Choose Your Card!</option>
<option>VISA </option>
<option>MasterCard </option>
<option>American Express </option>
<option>Discover </option>
</select> *</td>
</tr>
<tr>
<td align="right"><em>Cardholder name</em></td>
<td><input name="CardHolderName" size="35"> *</td>
</tr>
<tr>
<td align="right"><em>Card number</em></td>
<td><input name="CardNumber" size="35"> *</td>
</tr>
<tr>
<td align="right"><em>Expiration date</em></td>
<td><input name="CardExpiration" size="5" maxlength="5">* mm/yy</td>
</tr>
<tr><td colspan=2><p align=justify><strong>By signing your name (if form is mailed or faxed) or entering
your initials below (if form is submitted online), you are stating that you
are an authorized user of the above credit card and that you are authorizing Tracing
America to use this card for the services that we will be performing:</strong></p>
<div align="left"><p>Signature:
<hr>
Initials: <input name="Userinitials" size="6" value="">*</p>
</td></tr>
</table>
</blockquote>
<div align="left"><p><strong>How would you like the results of your search
transmitted to you?</strong></p>
</div>
<p align="center"><center>By: E-Mail<input checked name="resultsvia" type="radio" value="email"> Phone<input name="resultsvia" type="radio" value="phone">
Fax<input name="resultsvia" type="radio" value="fax">
Mailed to above address<input name="resultsvia" type="radio" value="snailmail"><br>
<strong>(<font color="#ff0000">a selection from above is required</font>)</strong></p>
</p>
<b>Information For Your Search:</b></center>
<br> Most searches have different requirements. If you need to go back to the particular search
to remember the code #, or the search requirements, please use your browser's
"back" button until you find the information you need, then use the
"forward" button to return here. Please fill out items below only if applicable
to your search:</p>
<table align=center>
<tr>
<td align="right"><em>Code Number</em></td>
<td><input name="subjCodeNumber" size="25">*</td>
</tr>
<tr>
<td align="right"><em>Subject's First name</em></td>
<td><input name="subjFirstName" size="25"> </td>
</tr>
<tr>
<td align="right"><em>Subject's Last name</em></td>
<td><input name="subjLastName" size="25"> </td>
</tr>
<tr>
<td align="right"><em>Subject's Middle initial</em></td>
<td><input name="subjMiddleInitial" size="4" maxlength="1"> </td>
</tr>
<tr>
<td align="right"><em>Street address</em></td>
<td><input name="subjStreetAddress" size="35"> </td>
</tr>
<tr>
<td align="right"><em>Current City</em></td>
<td><input name="subjCity" size="35"> </td>
</tr>
<tr>
<td align="right"><em>Current State/Province</em></td>
<td><input name="subjState" size="35"> </td>
</tr>
<tr>
<td align="right"><em>Current Zip code</em></td>
<td><input name="subjZipCode" size="12" maxlength="12"> </td>
</tr>
<tr>
<td align="right"><em>Last Known Address</em></td>
<td><input name="subjCountry" size="25"> </td>
</tr>
<tr>
<td align="right"><em>Last Known City</em></td>
<td><input name="subjHomePhone" size="25" maxlength="25"> </td>
</tr>
<tr>
<td align="right"><em>Last Known State</em></td>
<td><input name="LastState" size="25" maxlength="25"> </td>
</tr>
<tr>
<td align="right"><em>Last Known ZIP Code</em></td>
<td><input name="SubjLastzip" size="25"> </td>
</tr>
<tr>
<td align="right"><em>How long ago did subject live there?</em></td>
<td><input name="subjLengthlived" size="25" maxlength="25"></td>
</tr>
<tr>
<td align="right"><em>Social Security Number</em></td>
<td><input name="subjSS" size="25" maxlength="25"></td>
</tr>
<tr>
<td align="right"><em>Date of Birth</em></td>
<td><input name="subjDOB" size="25" maxlength="25"></td>
</tr>
<tr>
<td align="right"><em>Age</em></td>
<td><input name="subjage" size="6" maxlength="25"></td>
</tr>
<tr>
<td align="right"><em>Phone Number</em></td>
<td><input name="subjtelephone" size="25" maxlength="25"></td>
</tr>
<tr>
<td align="right"><em>Drivers License Number</em></td>
<td><input name="subjDLN" size="25" maxlength="25"></td>
</tr>
<tr>
<td align="right"><em>VIN</em></td>
<td><input name="subjVIN" size="25" maxlength="25"></td>
</tr>
<tr>
<td align="right"><em>Plate</em></td>
<td><input name="subjPlate" size="25" maxlength="25"></td>
</tr>
<tr>
<td align="right"><em>State to Search</em></td>
<td><input name="SearchState" size="25" maxlength="25"></td>
</tr>
</table>
</blockquote>
<table align=center>
<tr><td align="center"><b><p>Additional comments and/or information:</b></p>
</td></tr>
<tr><td>
<p><textarea name="comments" rows="5" cols="35"></textarea> </p>
</td></tr>
<tr><td align="center">Have you filled in all required fields ?
</td></tr>
<tr><td align="center"><input type="submit" value="Submit Form"> <input type="reset" value="Reset Form"> </p>
</td></tr></table>
<center>
<font color=FF0000 size=3><b>
<script language=javascript>
<!--
var contact = "If you experience problems ordering, click here."
var email = "info"
var emailHost = "tracingamerica.com"
document.write("<a href=" + "mail" + "to:" + email + "@" + emailHost+ ">" + contact + "</a>")
//-->
</script></b></font>
</center>
</form>
<center>
</td></tr></table><table border="0" cellpadding="0" cellspacing="0" width="100%"><tr><td>
<a href="body.asp"><img src="flag_home.gif" alt="Link To Home Page" width="160" height="60"></a>
<font size=4><b>
<script language=javascript>
<!--
var contact = "<img src=flag_email.gif width=160 height=60>"
var email = "info"
var emailHost = "tracingamerica.com"
document.write("<a href=" + "mail" + "to:" + email + "@" + emailHost+ ">" + contact + "</a>")
//-->
</script></b></font>
</center>
</td></tr></table>
</body>
]]>