Request a Change

REQUEST A CHANGE

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Your Name:

Company Name:

Street Address:

P.O. Box:

City:

State or Province:

Zip code or Postal code:

Phone:

Phone Ext:

Fax Number:

Email:

Please check the applicable products:

PER/ZIP4
PER/SORT
PER/RDI
Z4 LAT/LON
ZIP/CITY
CPC
SOQ
REPRINT

Please provide a narrative of why this change is being requested:

Complete one or more of the following sections:

We request the following machine serial number change to our software license.

	We will discontinue use of the indicated software on iSeries or AS/400 serial number on or about .
	We will begin use of the indicated software on iSeries or AS/400 serial number on or about .

Request Temporary Software Password

We request temporary use of the indicated software on iSeries or AS/400 serial number until the following date: .

Request Change of Shipping and/or Billing information

New Shipping Contact:

New Billing Contact: (If different than shipping):

Same as Shipping Contact

Your Name:

Company Name:

Street Address:

P.O. Box:

City:

State or Province:

Zip code or Postal code:

Phone:

Phone Ext:

Fax Number:

Email:

Security Code:

Print a copy of this page for your records. Fax the printed request to (601)856-9432 or submit your request by clicking on the SUBMIT button.

WorksRight Software, Inc. will contact you with your password(s) and other information as needed.

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