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*Company Name: *Contact Name: Address: City: State: Select Your State Alabama Alaska Arizona Arkansas California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusettes Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming International: Zip/Postal Code: *Email: *Phone: Does your Organization print and (or) manually Fax 2000 pages or more per month? Yes No Do you need to send documents from your desktop or from your enterprise application? Yes No Would it benefit your operation if you were able to receive confirmation that critical documents have been sent or received? Yes No Are there any areas of your business where it would be beneficial to reach customers faster with automated delivery of critical information? Yes No Does your organization print and mail more than 500 documents per month? Yes No Does your staff manually input information from documents received? Yes No Do you use an Enterprise Resource Planning system (ERP)? Yes No If yes, which ERP System (SAP, Peoplesoft, JD Edwars, etc)? What email platform do you use? Exchange Lotus Notes Other

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