LINE. DOTTEDALONG

CUTCUSTOMER:

FORM

ORDER

ACCESSORY

TOTAL

 

 

 

 

 

orcompletethisorderform.

PRICE*

$18.35

$8.75

$36.35

$11.90

 

 

 

 

 

(foraccessoriesonly)

MODELNUMBER

5-2562

5-2561

5-2425

5-2459

 

 

 

 

 

DESCRIPTION

ACpoweradapter

BeltClip

Headset

ReplacementHandsetBattery

Toorder,call1-800-338-0376

*Prices are subject to change without notice.

For credit card purchases

.........................................MerchandiseTotal $_______________

........................................................TaxSales $_______________

appropriatethecollecttolawbyrequiredareWe salestaxforeachindividualstate, merchandisethewhichtolocalityandcounty,isbeingsent.Dutieswillapplyfor Canada.toshipments

 

 

preferably.DiscoverorCardMasterorVISAUse MoneyorderorcheckmustbeinU.S. accessoriesAllCash.orCODNoonly.currencyaresubjecttoavailability.Where model.supersedingashipwillweapplicable,

 

 

 

.......................................Shipping/Handling$_______________

.................................EnclosedAmountTotal $_______________

 

 

 

 

 

 

 

 

 

 

$5.00

 

 

 

Yourcompletechargecardnumber,itsexpirationdateandyour signaturearenecessarytoprocessallchargecardorders.

 

CopyyourcompleteaccountnumberfromyourVISAcard.

 

 

 

 

Mycardexpires:

 

 

 

 

 

Copyyourcompleteaccountnumberfromyour

MasterCardorDiscover.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mailorderformandmoneyorderorcheck(inU.S.currency)

madepayabletoThomsonto:

 

Thomson

MailOrderDepartment

P.O.Box8419

Ronks,PA17573-8419

Name_______________________________________________________

AddressApt.____________

 

Copythenumberaboveyour

nameontheMasterCard

 

 

 

 

Mycardexpires:

 

 

____________________________________________________________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Authorized Signature

State ZIP_________________

)_______________________________

City________________________

DaytimePhoneNumber(

 

Pleasemakesurethatthisformhasbeenfilledoutcompletely.

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RCA 21011 manual Orcompletethisorderform