Method and system for entry of electronic data via fax-to-email communication

Mongo
Net

Send E-mail from a fax machine

free service from MongoNet

* Fill in e-mail address(s) in the boxes below

* Use this page as your fox cover sheet

* Fax for free to 1(800)345-8765

Use capital (uppercase) letters. Handprint each letter, number and sjrnbol as in the sample below:

To: (Write e-mail address here, keep each letter in the center of the box and use dark ink)

□□□□□□□□□□□□□□□□E3-61

^□□□□□□□□□□□□□□□r^63

Cc: (optional second e-mail address)

□□□□□□□□□□□□□□□□Q-6' [!□□□□□□□□□□□□□□□□

Cc: (optional third e-mail address)

□□□□□□□□□□□□□□□□0-61

[!□□□□□□□□□□□□□□□□

Freehand Notes and Drawings:

MongoFax Confirmation Page:

Your transmission was sent to the following e-mail address(s) or fax numberfs)
E-Mail: john_doe@generic.com
E-Mail: jane_doe@generic.com
Fax #:(415) 555.5555

If any of these addresses or fax numbers are incorrect,
please carefully fill out a new e-mail
address page and re-send.

Tear along dotted line. Tear along dotted lipe.