*

Company:

*

Address:

*

City:

* State: * Zip/Postal Code:

*

Country:

*

Contact Name:

Title:

*

Phone:

Fax:

*

E-mail:

Date Requested:

CPU Site (if different):

Address:

City:

State: Zip/Postal Code:

Country:

NGS Representative:

NGS Business Partner:

IBM Business Partner:

Web site:

Please check how you learned of our product:

Web
Ad
Directory
Seminar
Trade Show

Referral
Mailing
Other
Please specify:

Check Products Requested for Trial Period Evaluation

Entire NGS-IQ™ Suite
(IQ Server, Qport Builder, Qport Access, IQ SeQure, and SmartView)

Specific NGS-IQ Modules. Specify here:

Decision Assist™ - Financial Performance

Decision Assist™ - Business Performance

Decision Assist™ - Healthcare

Entire Concert Series™ Accounting Application Suite (GL, AP, AR, PR, HR)

Specific Concert Series Modules. Specify here:

Home Free™ UPS Utility

IBM i (AS/400) CPU Information (To display, use commands shown.)

Model:

Enter command: DSPSYSVAL QMODEL

Serial Number:

Enter command: DSPSYSVAL QSRLNBR

i5/OS or OS/400 Release:

Enter command: DSPPTF

Processor
Feature Code:

Enter command: DSPSYSVAL QPRCFEAT

Edition:

No. of processors activated for i5/OS (1-64):

Primary Business Software Application/Vendor:

All software is delivered on CD-ROM.

As an express condition of NGS granting me this trial period license, or any extensions thereto, I agree that the Product(s) is a copyrighted, proprietary product of NGS or its suppliers and I agree not to copy, disclose, or distribute the Product(s). I further agree that my use of the Product(s) is for Company’s evaluation purposes only and will be restricted to the above specified CPU and CPU site for 30 days or less. At the end of the Trial period, I will promptly return the Product(s) and any copies thereof, including associated documentation, to NGS. I agree to pay all reasonable shipping, media and handling charges for all media and documentation not returned to NGS within 30 days of the end of the trial period.

Agreed to for above Company:

* By:

* Title:

* Date: