Maryland Metrics Fax and Email Permission Form

The Federal Communications Commission (FCC) issued a Report and Order amending the
regulations that implement the Telephone Consumer Protection Act of 1991. Among the new
regulations were significant changes to the rules regarding faxes containing unsolicited
advertisements. These recently issued new regulations that affect your ability to receive
information via facsimile (fax) from Maryland Metrics.

Like many businesses these rules change the way Maryland Metrics conducts business via
facsimiles with our customers, potential customers and established business partners. To
comply with the new FCC rules, we ask that you complete and return this Fax/Email
Permission Form so we can continue to provide you with information on products and
services, invoices, packing lists, quotations, purchase orders, technical data,
advertisements and other business related documents.

These regulations go into affect on July 1, 2005. After that date, Maryland Metrics will
not be able to send you a facsimile without a signed consent form on file. It is important
that you complete and return this form as soon as possible in order to continue to receive
facsimiles and emails from Maryland Metrics.

We very much appreciate your assistance in trying to make certain that our company is in
compliance with these new regulations. We thank you for your understanding and we will
make every effort to return a similar form to your company promptly should you determine
that your business also requires this permission to remain in compliance..

By signing this form you will continue to receive facsimiles and emails.

Please contact Lee Sacks at (410)358-3130  (800)638-1830 or sales@mdmetric.com with any 
questions.

Please list all fax numbers that can be used to provide you with our information:

Fax #1:_________________________Fax #2:_________________________

Fax #3:_________________________Fax #4:_________________________

Fax #5:_________________________Fax #6:_________________________

Please list all email address that can be used to provide you with our information:

email #1:__________________________ email:#2:____________________________

email #3:__________________________ email #4:____________________________

I understand that by providing the fax number(s) and/or email addresses above, on behalf
of the company/organization specified above, I am fully authorized and hereby consent for
the company/organization to receive notices, announcements, brochures, advertisements, and
other information sent by or on behalf of Maryland Metrics via facsimile, telephone or 
email. I further agree that my express permission to fax, telephone, or e-mail me such
notices and other information will continue and have no date of expiration, unless a
written request is received revoking permission.

Company/Organization Name:________________________________________

Authorized Representative:______________________________ Title:________________________

Signature:______________________________________________________   Date:___/___/0__

Please return this form by July 1, 2005 via fax to (410)358-3142 or (800)872-9329 or via 
mail to:                                            or by email to: sales@mdmetric.com
Maryland Metrics
Attn: Lee Sacks
P.O. Box 261
Owings Mills, MD 21117 USA                                                   ver a27f