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Attention: Transmitter Ordering Department
Important: To help us expedite your order, please print all
of the information legibly and mail this form and your pay-
ment according to the instructions below.
1) Name:_____________________________________
2) Address:_________________________________________
3) City:________________State:________Zip Code:__________
4) Telephone Number: ( )_____________________
5) Total Number Of Transmitters Required:_______
Cost Per Transmitter is: $65.00
Multiply By Number Of Transmitters X
6) Enter Total Amount Enclosed: _______
(New York State Residents must include the appropriate sales tax)
7) Method of Payment:
Mastercard Visa Check or Money Order (do not send cash)
Make Checks Payable To Audiovox Corporation
Credit Card Number:___________________________________
Credit Card Expiration Date: ____/___/____
8) Mail this form along with your payment to:
Transmitter Ordering Department
Audiovox Corporation 150 Marcus Blvd., Hauppauge N.Y.
11788
Credit card purchasers can order additional or replacement
transmitters by phone. Simply dial 1 - 800 - 645 - 4994, and
follow the instructions from the operator interface.
ORDER FORM
FOR TRANSMITTER 09XR1Pr
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