13225 Tukwila Int'l Blvd. #215, Tukwila, Washington, 98168-3179 Email: Ed@RaysTackle.com  Phone: 1-866-434-7311

Personal Check - Certified Check - Money Order form Wecolme, you have made one of the best decisions in your life by ordering the Smart Box charging system! Remember You get to try the charger in the worst, toughest conditions you can for 90 days risk free and if you don't like it, you don't keep it!  And you get the best warranty on any charging box which is a 3 year replacement warranty, if the Smart Box fails to work even after you have had it for 2 years 11 months and 29 days the manufacturer will replace it. OH and don't forget about the bribe we are sending in the package just to get you to test the Smart Box for 90 days risk free. All orders are shipped 48 hours after the bank clears the personal check, certified check or money order, Monday through Saturday. Instructions: 1.  Print 2 copies of this form. 2.  Fill in all the information completely on both copies of this form. 3.  Check if you are paying with a personal check, certified check or money order. 4.  Double check to see if the mailing address, phone number and email is correct. 5.  Sign your name at the bottom and date the form. 6.  Put one completed form and your personal check, certified check or money order in an envelope and mail it to the address printed at the bottom of this form. Keep the second copy for your records. Paying with:     ____Personal check   ____Certified check    ____Money order Check or Money order number: _______________________ Product & Number: Smart Box charging system Item #1006BT71 First name: __________________ Last name: __________________ Email: ______________________ Phone number with area code: ___________ - _________ - _________________ Address: __________________________________________________________ City: _____________________________________ State or Province: ___________________________ Zip Code: _________________________________ If the shipping address is different from your mailing address please list the shipping address below. Shipping address: ___________________________________________________ City: ___________________________________ State or Province: ___________________________ Zip Code: __________________________________ Sign your name here: _____________________________________________ Date signed: __________________________________ NOTE: Please check to make sure all the information entered is correct. If it is put one copy with your check or money order into an envelope and mail the envelope to the following address. Ray's Tackle Shop; 13225 Tukwila Int'l Blvd. #215; Tukwila, Washington 98168-3179 If you still have any questions please call toll free 1-866-434-7311 and we will answer all your questions or email us at Ed@RaysTackle.com Thank you for the order and we know after you have tested the Smart Box for 90 days risk free you will be extremely glad you bought the Smart Box charging system.