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BOX OF TEN (10)
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1. Print this form and complete it. Please write clearly
First Name:_______________________________ Last Name:________________________________
Address:___________________________________________________________________________
City:_____________________________________State:_______ Zip:__________________________
2. Please affix, a total of 1,000 Max Points to the BACK of this form.
3. Make $5.00 check or money order payable to: DBA
4. Mail completed form and check or money order to:
TDK SA-X LIMITED OFFER
c/o DBA
24 East 21st Street, 3rd Floor
New York, NY 10010
This offer is limited to ten (10) SA-X Limited audio tapes per individual, family, household or address.
Please do not send request for SA-X Limited tape in the same envelope with any other TDK Max Points offers.