Order Form

To place an order, complete and print this order form first. Then send it along with your video tapes and payment to our lab at the address below. We accept personal checks and money orders. Please make your check payable to Distributed Systems, Inc. We cannot be held responsible for your tapes lost or damaged in mail. Therefore, please use a trackable service such as US Postal Service with a delivery confirmation or other third-party delivery services. Also we do not accept adult materials and copyrighted materials without a copyright owner's consent.

Our Address :

Distributed Systems, Inc. 1582 First Ave #1C New York, NY, 10028

Customer Information
First Name :
Last Name :
Address :
City :
State :	AL AK AS AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX VA VT WA WV WI WY
Zipcode :
Phone :
Email :

Video Tapes Information
Tape Number:	1 2 3 4 5 6 7 8 9 10
Tapes IDs:
Please label each tape with a name. Enter the name and format of each tape in the spaces above one tape a row.

Basic Service
Title Number:	0 1 2 3 4 5 6 7 8 9 10
	Basic Service Total:

Enhanced Service
Title Number:	0 1 2 3 4 5 6 7 8 9 10
Enhanced Service Total:

Order Total
Service Total:
Sale Tax (MA:5%):
Shipping:
Order Total:

Instructions

We need your instructions to tell us how to process your DVDs and what video should be put on each DVD title. Please complete the instruction section below before print out your order.

If you have additional instructions and questions, please write down to a new sheet of paper and attach it to this order form. Click on the "PRINT MY ORDER" button to print out your order form once your finishing entering information. Please print out an additional copy of this form for future reference.