To : SAFIA LICENSE GROUP 
  e-mail:info@safia-lb.com 

                       " NOTOCE  Form"
              ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

�@�@Please write in BLOCK CAPITALS in ink.

   Date:
   
�@ Categry:   1)Evaluator                2)Reseller  
              3)Adopter(StorageDevice)   4)Adopter(TV Recording)
              5)Adopter(Audio) 
                                               ��Please check the number.

   Company:

   Contact Person Contact Name:  Mr. / Ms. / (           )

   Contact Person Position:

   Contact Person Department/Group:

   Contact Person Mailing Address:

   Contact Person Phone:

   Contact Person Fax:

   Contact Person E-mail:

   Company website: English	http://
                    Japanese	http://
                    * This will be added to the list of members on our website.