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New York, NY 10016-5991
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Date
__________________________________________________
First Name
__________________________________________________
Last Name
__________________________________________________
E-mail Address
__________________________________________________
Daytime Phone Number
__________________________________________________
CPA?
___
Yes ___ No
State Certified?
___
Yes ___ No
Subscription Rates
Term
U.S.
Student
Foreign
1 Year
$42
___
$21
___
$54
___
2 Years
$74
___
$39
___
$98
___
3 Years
$99
___
N/A
$135
___
Credit Card Information
Credit Card
___ Master Card ___ Visa ___ Amex
Name on the Credit Card
__________________________________________________
Account #
__________________________________________________
Exp. Date
__________________________________________________
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