Allowance Request Form
Please print out first and fill it, then deliver it with your ELSA card to dealer.
Allowance request for upgrade will not be processed if you left any column blank.
Allowance program period from 09/01/2003 to 12/31/2003

Leadtek product you request to upgrade :
Leadtek Quadro FX2000
Leadtek Quadro FX1000
Leadtek Quadro FX500
Leadtek Quadro4 380XGL
Leadtek Quadro4 980XGL    

ELSA product you bought :
Synergy
Gloria
  
Winner
  
Serial no.
   Card situation : ¡¼Normal¡¼Abnormal¡¼Damage

Personal information
Where & When you bought ELSA
Your Name   Country & City  
Country & City   Distributor name  
E-mail Address   Distributor Tel  
Your Tel   Dealer name  
Your job function   Dealer Tel  
Company name   Purchase date (yy/mm)  
Company addr   Company Tel  

What applications you are using: , version
CAD/CAM Pro/E, Unigraphics, UG/SDRC, Solidworks, Solid Edge, I-DEAS, Alias, CATIA, Inventor MDT, Auto CAD, Inventor
DCC 3DS Max, Softimage, Maya, Lightwave, Combustion, Houdini, StudioTools
ACE Microstation 3D Studio VIZ
Financial Bloomberg, Reuters, Tradestation
Business Hummingbird Exceed, Lotus Notes, McAfee Virus Scan, MS Office Siut, pcAnywhere

Confirmation for Product Information
(Confirmed & filled by dealer & distributor)

Distributor Name. (Filled by distributer only)
County/City / (Filled by distributer only)
Date (yy/mm/dd) (Filled by distributer only)
Dealer Name. (Filled by dealer only)
Date (yy/mm/dd) (Filled by dealer only)

ELSA product information-must be confirmed to match the print on PCB:
Synergy , Gloria , Winner
Serial no. , Card situation : Normal Abnormal Damage

Leadtek product customer upgrade:

Leadtek Quadro FX2000
Leadtek Quadro FX1000
Leadtek Quadro FX500
Leadtek Quadro4 380XGL
Leadtek Quadro4 980XGL    
Leadtek product Serial no. , Allowance of US$


Distributors must complete this confirmation and return this form to Leadtek.

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