Order Form

PLEASE RETURN WITH YOUR REMITTANCE OR PURCHASE ORDER

Please send us the following loose-leaf books:

QTY
____     Book B (Adjudication) - $73.00  (initial loose-leaf service plus one year update service)
____     Book C (Schedule for Rating Disabilities) - $64.00  (initial loose-leaf service plus one year update service)

Please send the loose-leaf book(s) and all supplements to the following address:*

Office: ___________________________________________________________

Attention: _________________________________________________________

Address: _________________________________________________________

               __________________________________________________________

City: ________________________   State: _________  Zip: _________________

Remittance is being made in the following form:

(  )  Check      (  ) Money Order     (  ) Purchase Order

We do not accept credit cards; please send a check or money order with this form.

* If you are ordering multiple copies, and wish the books or the updates sent directly to a specific address, just attach a distribution list to your order form.

Jonathan Publishing
855 Yorks Crossing
Driftwood TX 78619

512/858-1225

Fax: 512/858-1230