Detach here – GE CG400 User Manual

Page 10

Detach Here

✂

Charge your order on your VISA

or MasterCard by

filling in below

USE YOUR CREDIT CARD

IMPORTANT: Copy complete account number

from your VISA card

IMPORTANT: Copy complete account number

from your MasterCard

My card expires:

My card
expires:

Copy Number

above your

name on

MasterCard

AUTHORIZED SIGNATURE

Prices are subject to change without notice.

Name:

Street:

Apt:

City:

State:

Zip:

Print or type your name and
address clearly. This will be your
mailing label.

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

A complete and correct order will
save you days of waiting.