RCA 25403/04 manual Accessory Order Form

Other Information

Accessory Order Form

	To Order
	To place your order by phone, have
	your Visa, MasterCard or Discover
	Card ready and call the toll-free
	number listed below.
	Use this number only to place an
	order for accessory items listed on
	this order form.
	1-800-338-0376
	To place your order by mail, detach
	and mail the completed order form
	with credit card information, money
	order or check in US currency (made
	payable to Thomson multimedia Inc.)
	to the following address:
	Thomson Inc.
	Mail Order Department
✂	PO Box 8419
DetachHere	Ronks, PA 17573-8419

	Charge your order on your VISA,
	MasterCard, or Discover Card by
	filling in below
USE YOUR CREDIT CARD
				®
IMPORTANT: Copy complete account number
	from your VISA card
	My card expires:
IMPORTANT: Copy complete account number		s	r	r	TM
	from your MasterCard
Copy Number	My card
above your	expires:
name on
MasterCard
IMPORTANT: Copy complete account number
	from your Discover Card
	My card expires:
	AUTHORIZED SIGNATURE
(Credit card order will not be processed without signature)

Print or type your name and	A complete and correct
address clearly.	order will save you days
	of waiting.

Name:

Street:

Apt:

City:

State:Zip:

Daytime phone number:

Please make sure that both sides of this form have been filled out completely.

•Allow 4 weeks for delivery.

•All accessories are subject to availability.

•Prices are subject to change.

AC power adapter		Headset
5-2495		5-2425
Description	Part No.	Price	Qty Total
AC power adapter	5-2495	$20.85
Headset	5-2425	$19.95
Prices are subject to change without notice.
Total Merchandise		$	_______
Sales Tax		$	_______
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.
Shipping and Handling		$	5.00
Total Amount Enclosed		$	_______
Use VISA, MasterCard, or Discover Card 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.

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