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A division of the American Chemical Society
                                                                    ClientServices        Phone: 800-631-1884, 614-447-3870
                                                                                                            Fax: 614-447-3747
                                                                                                        E-mail: answers@cas.org
                                                                                              Web: www.cas.org/products/client/

 Registry Lookup Order Form

Customer Requesting Information:

Name __________________________________________________________________________________________
Organization_____________________________________________________________________________________
Address ________________________________________________________________________________________
          ________________________________________________________________________________________
          ________________________________________________________________________________________
Telephone __________________________________________                            Telefax _______________________________


Payment Information:                   Bill Me        Purchase Order # _______________________________________

                                       VISA           MasterCard                American Express
                                       Expiration Date _______________________
                                       Credit Card Account # ___________________________________________________


Client Services Registry Lookup

CAS Registry Lookup will perform a computer-match of your chemical name or CAS Registry NumberŪ against the CAS
RegistrySM File. The results of the search will be returned to you within 24 hours (excluding holidays and weekends).
If your chemical name or CAS Registry Number matches a record in the Registry File a print for that record will be
returned with your results. The cost of this processing is $25.00 per item searched.


Please Search:
                                        CAS Registry Number(s):      ___________________________________________
                                                                     ___________________________________________
                                                                     ___________________________________________

                                        Chemical Name(s):            ___________________________________________
                                                                     ___________________________________________
                                                                     ___________________________________________



A signature below is required before the requested Registry Lookup will be performed. This acknowledges
acceptance of the CAS Client Services Terms and Conditions and CAS Information Use Policies.

Authorized Signature _______________________________________                          Date ________________________




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