Magnadyne MV-DVD-PL3 Replacement Parts Order Form, No C.O.D.’s, ATTN Consumer Parts Sales, City

Replacement Parts Order Form

Send Orders To: Magnadyne Corporation						We Accept Checks, Money Orders, Visa and Master Card
			ATTN: Consumer Parts Sales			Make Checks Payable to: Magnadyne Corporation
			P. O. Box 5365
			Carson, CA 90749-5365
	SHIP TO: (No P.O. Boxes)
	LAST NAME				FIRST NAME					INITIAL
	STREET ADDRESS (IF PAYING WITH A CREDIT CARD, YOUR BILLING ADDRESS IS REQUIRED)
	CITY				STATE			ZIP CODE
	DAYTIME PHONE NUMBER
	CREDIT CARD INFORMATION:
		VISA		MASTER CARD
	CARD TYPE:
	CARD NUMBER						EXP. MONTH		YEAR

NAME - EXACTLY AS IT APPEARS ON YOUR CREDIT CARD

Part #

Description

Qty.

Price Each

TOTAL

MV-2000RM

Remote Control

$39.95

Shipping and Handling

Subtotal + Tax	Add
Up to $20.00	$5.00
20.01 to 30.00	5.95
30.01 to 45.00	6.50
45.01 to 70.00	6.95
Over 70.01	7.95

Subtotal = ________ . ______

California Residents Add Sales Tax = ________ . ______

Shipping and Handling (See Chart) = ________ . ______

TOTAL = ________ . ______

No C.O.D.’s

On regular orders please allow 4-5 weeks for delivery. Please give a shipping address where this order

may be delivered between the hours of 9 a.m. and 5 p.m. weekdays. If UPS is unable to deliver, your order will be

returned and additional shipping charges will be required.

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