Audiovox manual ORDERFORMFORAX-2K4AX-2K4S,AX-2K4MS,AX-2K4MSFL, Department

ORDERFORMFORAX-2K4AX-2K4S,AX-2K4MS,AX-2K4MSFL

Attention: Transmitter Ordering

Department

Important: To help us expedite your order, please print all of the infor- mation legibly and mail this form and your payment according to the instructions below.

Indicate the pad number of your transmitter selected from the pads shown above.

Note: Transmitter model number found on back of case.

AX-2K4MSFL Main use PD 110, Side use 111

1)Pad Number:_________________________________

2)Name: _______________________________________

3)Address: ______________________________________

4)City: ________________ State: _____ Zip Code: ________

5)Telephone Number: (_____) _______________

6)Total Number Of Transmitters Required:

Cost Per Transmitter is:	$65.00
Multiply By Number Of Transmitters	X ______

7) Enter Total Amount Enclosed _________________

(New York State Residents must include the appropriate sales tax)

8) Method of Payment:

￿Mastercard ￿ Visa ￿ Check or Money Order (do not send cash) Make Checks Payable To Audiovox Corporation

Credit Card Number: _________________________________

Credit Card Expiration Date: ____ / _____ / _____

9) Mail this form along with your payment to:

Credit card purchasers can order additional or replacement

￿transmitters by phone. Simply dial 1 - 800 - 645 - 4994, and follow the instructions from the operator interface.

Audiovox Electronics Corp., 150 Marcus Blvd., Hauppauge, N.Y., 11788

Attn.: TRANSMITTER DEPARTMENT

© 2003 Audiovox Electronics Corp., 150 Marcus Blvd., Hauppauge, NY, 11788 128-6987

128-6987

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