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Please complete this form regarding the delivery of your IEEE publications. This information will help expedite your request and will enable a prompt response to your questions or comments.

Please make claims for missing issues in writing within six months of delivery date (12 months for subscribers outside the U.S. and Canada). Issues claimed after this time will be billed at the single copy rate. Paper editions are only available for two years (quantities are limited).




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 Personal Information  
Account Name:
Account Number:
First (Given) Name:*
Last (Family) Name :*
E-mail Address :*
 Mailing Information
Full Billing Address:
Full Shipping Address:
Publication Information
Are you missing any IEEE publications?

Yes
No, but delivery is delayed.
Please provide the following information:  
1. Publication Name: 
    Issue Dates:
    Delivery Method:
    Payment Details: Credit Card
Wire Transfer
Check
       If you selected Check, enter Check Number:
       
    Order Number:
    Purchase Order Number:
   
2. Publication Name:
    Issue Dates:
    Delivery Method:
    Payment Details: Credit Card
Wire Transfer
Check
       If you selected Check, enter Check Number:
       
    Order Number:
    Purchase Order Number:
   
3. Publication Name:
    Issue Dates:
    Delivery Method:
    Payment Details: Credit Card
Wire Transfer
Check
       If you selected Check, enter Check Number:
       
    Order Number:
    Purchase Order Number:
   
4. Publication Name:
    Issue Dates:
    Delivery Method:
    Payment Details: Credit Card
Wire Transfer
Check
       If you selected Check, enter Check Number:
       
    Order Number:
    Purchase Order Number:
   
5. Publication Name:
    Issue Dates:
    Delivery Method:
    Payment Details: Credit Card
Wire Transfer
Check
       If you selected Check, enter Check Number:
       
    Order Number:
    Purchase Order Number:
   

Have you previously contacted IEEE about the delivery of your publication(s)? Yes
No
If yes, when did you contact IEEE?
   
   
Select other IEEE mailing you may be missing:
If you indicated "Other",  please list:

 Additional Information
Supporting File: (Acceptable file formats: JPG, GIF, DOC, PDF
Maximum File Size = 512 KB)

Comments:
 



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