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Accessory Order Form
DESCRIPTION
For credit card purchases
Your complete charge card number, its expiration date and
your signature are necessary to process all charge card
orders.
Copy your complete account number from your VISA card.
My card expires:
Copy your complete account number from your MasterCard.
Copy the number above your
name on the MasterCard
My card expires:
____________________________________________________________________
Authorized Signature
Please make sure that this form has been filled out completely.
CATALOG NUMBER
PRICE*
*Prices are subject to change without notice.
Total
Merchandise ............................................................. $ ______________
We are required by law to collect the appropriate sales tax for each individual state, county,
and locality to which the merchandise is being sent.
Use VISA or MasterCard preferably. Money order or check must be in U.S. currency only. No
COD or Cash.
All accessories are subject to availability. Where applicable, we will ship a superseding
model.
Sales Tax ................................................................... $_______________
Shipping, Handling, and Insurance ...................... $_______________
Total Amount Enclosed .......................................... $_______________
Mail order form and money order or check (in U.S. currency) made
payable to Thomson Consumer Electronics, Inc. to:
Consumer Electronics, Mail Order Department
P.O. Box 8419
Ronks, PA 17573-8419
This is your return label. Please print clearly.
To:
Name________________________________________________________
Address_____________________________________ Apt.____________
City ________________________State________ ZIP_________________
QUANTITY
TOTAL
$5.00
33
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