Manual

Charge ytour order on your VISA MasterCard

or D scover Card by fill ng in below

USE YOUR CREDIT CARD

|MPORTANT: Copy complete account numbm from your VISA card /_

17777177717771777 E_,,_,t,o_a_,o:g_l g_l

[MPORTANT: (opy complete account numbm from your Master(ard

7TTT7 VTTT7 7TTT7 7TTT7

CopyNumberaboveyournameonM&*,tcrCard _ Expirationdate:[_7[_7

II'_IPORI'AN'|': (opy complete account number fi'om your Discover (ard

gYYYq gYYYq V7777 VTTTq

Expiration date: [77 [77

AUTHORIZED SIGNATURE

Prices me subject to change without notice

Print or type your name and A complete and correct order will

address clearly, save you days of waiting.

Name:

Street:

City:

State'

Daytime Phone No.:

Apt:

Zip:

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

• Allow 4 weeks for delivery.

• All accessories are subject to availability.