Please print this form and fully complete all areas.
Make your check or money payable to New Remotes, Inc.
& mail with the completed form to:
New Remotes, Inc.
Electronic Adventure
12914 Dupont Circle
Tampa FL 33626
Name: ___________________________________________________
Address: _________________________________________________
Address: _________________________________________________
City: ____________________________________________________
State: _________________
Zip Code: ______________
Phone: _____________________________
Remote model brand & number: ______________________________
Quantity: ___________
Price: $______________
Total cost: (quantity X price) $__________________
Shipping & handling: $7.99 USA, $11.99 Canada
Sales tax: (Florida residents only - 8.5%) $______________
Grand total: $____________________________
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