GE 2-9975 - Manual (Page 29)

CUSTOMER: CUT ALONG DOTTED LINE. ---------
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DESCRIPTION CATALOG NUMBER PRICE* QUANTITY TOTAL
AC power supply adapter 5-2380 $9.95
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For credit card purchases
Your complete charge card number, its expiration date and your
signature are necessary to process all charge card orders.
Copy your complete account number from your VISA card.
My card expires:
Copy your complete account number from your MasterCard.
Copy the number above your
name on the MasterCard
My card expires:
*Prices are subject to change without notica.
Total Merchandise........................................... $_____________
We are required by lew to collect the apgropriate sales tax for each individual state, county,
and locality to which the merchandise is being sent
Sales Tax.......................................................... $_____________
Use VISA or MasterCard preferably .Money order or check must be in U.S. currency only. No
COD or Cash.
All accessaries are subject to availability. Where applicable, we will ship a superseding
model. J5QQ
Shipping, Handling, and Insurance............... $_____________
Total Amount Enclosed...................................$_____________
Mail order form and money order or check (in U.S. currency! made payable to
Thomson Consumer Electronics, Inc. to:
Consumer Electronics
Mail Order Department
P.O. Box 8419
Ronks, PA 17573-8419
This is your return label. Please print clearly.To:
Name__________________________________________________
Address_________________________________ Apt.___________
City______________________ State_______ ZIP_______________
Authorized Signature
Please make sure that this form has been filled out completely.