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  1.  
  2.  
  3.  
  4.    Please FAX this form to:  1-800-760-2200
  5.    Or mail the form to:      CANON COMPUTER SYSTEMS, INC.
  6.                              DEPT POWERSHOT E-REG
  7.                              P.O. BOX 430903-9900
  8.                              EL PASO TX 88543-9900
  9.  
  10.    Please do not send a cover page with this fax.
  11.    ----------------------------------------------------------------------------
  12.    Form ID: $(Registration.400,12)
  13.    Q1.... Name (First/Init/Last):  $(Registration.201,14) $(Registration.202,1) $(Registration.203,16)
  14.           Company Name:            $(Registration.204,30)
  15.           Address1:                $(Registration.213,30)
  16.           Address2:                $(Registration.214,30)
  17.           City, State, Zip:        $(Registration.215,17), $(Registration.216,2)  $(Registration.217,6)
  18.           Country:                 $(Registration.218,20)
  19.  
  20.           Address Code: $(Registration.101,1)            Address Type: $(Registration.102,1)
  21.           Home Phone: $(Registration.219,3)$(Registration.220,7)  Fax Phone: $(Registration.209,3)$(Registration.210,7)  Bus Phone: $(Registration.206,3)$(Registration.207,7)
  22.           Email Address: $(Registration.223,50)
  23.  
  24.    Q2.... Date of Purchase (Month/Day/Year): $(Registration.224,6)
  25.  
  26.    Q3.... Model #: $(Registration.252,20)       Serial #: $(Registration.1434,15)
  27.  
  28.    Q4.... $(Marketing.3000,30)
  29.  
  30.    Q5.... $(Marketing.1000,10)
  31.  
  32.    Q6.... $(Marketing.1010,24)
  33.  
  34.    Q7.... $(Marketing.6000,36)
  35.  
  36.    Q8.... $(Marketing.6010,36)
  37.  
  38.    Q9.... $(Marketing.1020,12)
  39.  
  40.    Q10.... $(Marketing.6020,38)
  41.  
  42.    Q11.... $(Marketing.3010,28)
  43.  
  44.    Q12.... $(Marketing.1300,36)
  45.  
  46.    Q13.... $(Marketing.6030,60)
  47.  
  48.    Q14.... $(Marketing.6040,36)
  49.  
  50.    Q15.... $(Marketing.1030,12)
  51.  
  52.    Q16.... $(Marketing.6050,36)
  53.  
  54.    Q17.... $(Marketing.6060,36)
  55.  
  56.    Q18.... $(Marketing.6070,42)