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P. O. BOX 07280, DETROIT, MICHIGAN 48207
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NOTE: Dealers and Companies please provide dealer or company name, and alsothe nameof the person to
whose attention the shipment shouldbe sent.
Customer Name
Attention
Street address/P. O. BOX Apartment Number
City State Zip Code
Daytime Telephone Number
Check ormoney order enclosed payable to Helm Inc. U. S.funds only. Do notsend cash.
Check hereif your billing address isdifferent from theshipping address shownabove.
VISA DiscoverMasterCard
Account Number Expiration: Mo. Yr.
Customer Signature Date
These Publications cannot be returned for credit without receiving advance authorization within 14 days ofdelivery. For
returns, arestocking feemay be applied against the original order.
Security Code
()
HELM
190
Consumer Information
１０／０６／０３ ０９：３３：０２ ３１ＨＮ６６９０ ０１９９
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