NOTE:
Dealers and Companies please provide dealer or company name, and also the
name of the person to whose attention the shipment should be sent.
Mail completed order form to:
For purchases outside U.S.A. please write to the above address for quotation.
HELM, INCORPORATED
P.O.
Box
07130
Detroit, MI 48207
(CUSTOMER’S NAME) (ATTENTION)
(STREET ADDRESS-NO
P.O.
BOX NUMBERS)
(C1l-Y) (STATE)
(ZIP
CODE)
DAYTIME TELEPHONE
NO.
0
AREA CODE
HE-ORD97 *(Prices are subject
to
change without notice and without incurring
obligation. Allow ample time for delivery.)
-
P
A
Y
M
E
N
T
Cheek
or Money
Order payable
to
Helm,
Inc.
(USA
funds
only
-
da
not send cash.)
0
MasterCard
c]
VISA
Expiration
Date
mot’yr:
mc
Note to Canadian Customers: All listed prices are quoted in
U.S.
funds. Canadian residents
are to make checks payable in
U.S.
funds.
To
cover Canadian postage, add
$11.50
plus the
U.S. order processing.
