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ORDER FORM FOR 4 BUTTON
TRANSMITTER MODEL NO. PRO-OE4BS
Important: To help us expedite your order, please print all of the
information legibly and mail this form and your payment
according to the instructions below.
Note: Order PD-40 for Blue transmitter buttons.
Order PD-41 for Red transmitter buttons.
1) Pad Number:_____________________________________
2) Name: __________________________________________
3) Address: ________________________________________
4) City:____________ State: ____ Zip Code: __________
5) Telephone Number: ( )
6) Total Number Of Transmitters Required:
Cost Per Transmitter is: $65.00
Multiply By Number Of Transmitters X
7) Enter Total Amount Enclosed
(New York State Residents must include the appropriate sales tax)
8) 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: / /
9) Mail this form along with your payment to:
128-5868
Audiovox Electronics Corp., 150 Marcus Blvd. Hauppauge, NY, 11788
Attn.: TRANSMITTER DEPARTMENT