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216
Consumer Information
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P. O. BOX 07280, DETROIT, MICHIGAN 48207
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Customer Name
Attention
Apartment NumberStreet address/P.O. BOX
Zip CodeStateCity
Daytime Telephone Number
Check or money order enclosed payable to Helm Inc. U. S. funds only. Do not send cash.
Check here if your billing address is different from the shipping address shown above.
DiscoverVISA MasterCard
Expiration: Mo. Yr.Account Number
Security Code
DateCustomer Signature
These Publications cannot be returned for credit without receiving advance authorization within 14 days of delivery.
For returns, a restocking fee may be applied against the original order.
( )
HELM
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.
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