STEP 1a: Provide Personal Information
First Name
Last Name
Company
Street Address (Note: PO Box not Accepted)
Address (cont)
City
State (Note: Florida residents pay sales tax)
Choose One
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Florida County (Note: If Florida resident then County required)
Choose One
Alachua
Baker
Bay
Bradford
Brevard
Broward
Calhoun
Charlotte
Citrus
Clay
Collier
Columbia
De Soto
Dixie
Duval
Escambia
Flagler
Franklin
Gadsden
Gilchrist
Glades
Gulf
Hamilton
Hardee
Hendry
Hernando
Highlands
Hillsborough
Holmes
Indian River
Jackson
Jefferson
Lafayette
Lake
Lee
Leon
Levy
Liberty
Madison
Manatee
Marion
Martin
Miami Dade
Monroe
Nassau
Okaloosa
Okeechobee
Orange
Osceola
Palm Beach
Pasco
Pinellas
Polk
Putnam
St. Johns
St. Lucie
Santa Rosa
Sarasota
Seminole
Sumter
Suwannee
Taylor
Union
Volusia
Wakulla
Walton
Washington
Zip Code
E-mail Address
Phone Number
Fax Number
Business Type
Choose One
Accounting/Payroll Firm
CPA Firm
Individual Business
Lawyers Office
STEP 1b: Alternate Contact's Information
First Name
Last Name
E-mail Address
Phone Number
STEP 2: Select your payment option
Name (as it appears on credit card)
Billing Address same as above?
Billing Address (Note: PO Box not Accepted)
Billing City
BillingState (Note: Florida residents pay sales tax)
Choose One
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Billing Zip Code
Credit Card Type
Visa
MasterCard
American Express
Discover
Diners Club
Credit Card Number
Credit Card Security Code
Expiration Date
Select Month
01-Jan
02-Feb
03-Mar
04-Apr
05-May
06-Jun
07-Jul
08-Aug
09-Sep
10-Oct
11-Nov
12-Dec
Select Year
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
STEP 3: Select your product(s)
(See product descriptions below under Notes:)
Product Description
Price
QTY
Florida Unemployment Compliance Tax Program (UCT-6)
$199
QTY
1
2
3
4
5
Florida Premium Unemployment Compliance Tax Program (UCT-6)
$399
QTY
1
2
3
4
5
Florida Premium Unemployment Compliance Tax Program (UPGRADE) (This option is only available to users who have already purchased the basic package at $199.00 and want to upgrade to the premium package at $399.00)
$200
QTY
1
2
3
4
5
Florida Unlimited Unemployment Compliance Tax Program (UCT-6)
$499
QTY
1
2
3
4
5
Georgia Unemployment Compliance Tax Program (DOL-4)
$199
QTY
1
2
3
4
5
Georgia Premium Unemployment Compliance Tax Program (DOL-4)
$299
QTY
1
2
3
4
5
Georgia Unlimited Unemployment Compliance Tax Program (DOL-4)
$399
QTY
1
2
3
4
5
STEP 4: Optional Copy of CD Software
If you would like a copy of the CD shipped to you, please choose one of the following delivery options:
Web Download (No Charge)
CD Installation & Updates - $50 (Applicable taxes will be appied for Florida Residents )
Comments? Questions? Click and type in the box.
Please call us toll free(800) 270-3643
STEP 5: Submit this order for processing
2010 Pro T ax Software You will receive an order confirmation email within 24 hours of placing this order.
If you chose the "Web Download" option you will receive an email with a link to install the software when it is made available (March
2010)
If you chose one of the shipping options you will receive the installation email as well as a CD to install the software when it is made available (March
2010)
NOTES: (Please read carefully) The
ProTax Limited Unemployment Programs include, 10 or less companies a year
with an annual payroll of less than $500,000 per year per
company.
The Limited Programs will not process any payroll over
$500,000. If your total annual payroll is over $500,000, you
must purchase the Premium or Unlimited.
The ProTax Premium Programs include, 10 or more companies
a year with an annual payroll of $500,000 or greater.
(The Premium Program does not include the Network
Module.)
The ProTax Unlimited Unemployment Programs
include, 10 or more companies a year with an annual payroll
of $500,000 or greater and does
include the Network Module.
The multi-location license is required for each
additional business location using the software. The cost of
the license is 50% of the subtotal (per location).
Florida Sales tax is NOT required to be paid on a Web
Download of the program.
I have read and understand the notes.