Eureka 77 warranty Qty Price USD Total, $5.50

	The Eureka Company	1/03
		ORDER FORM
VACUUM CLEANERS	P.O. Box 2799
	Bloomington, IL 61702-2799

(Not applicable in Canada)

S O L D

T O

Name

Address (street address needed for UPS)

City	State	Zip
Telephone (Day)	(Eve)	(Fax)

S H I P

T O

Name

Address (street address needed for UPS)

City	State	Zip
Telephone (Day)	(Eve)	(Fax)

To Order

By Phone

HOURS:

Call between 8 a.m.

central standard time Monday through Friday.

By FAX

1-309-823-5789

*En Mexico llame al

5670-6169

By Mail

Simply fill out this

Order Form.

Please be sure to

include day and evening phone numbers.

ON-LINE

www.eureka.com

72208

__________________

Part No.

Qty.

Price (USD)

Total

Model Number

Genuine Eureka Parts

__________________

Motor Filter

61881

.99

Type

__________________

Serial Number

Wall Mount

61884

3.99

IMPORTANT:

Adaptor

61885

7.99

Be sure to include

your model, type, and

serial numbers. These

numbers may be

To Answer Problems or Questions for U.S.A. and Canada call:

Total (prices subject to change without notice)

found on the rating

1-800-282-2886*

plate.

8 a.m. - 7:30 p.m. (CST) Monday - Friday and 10 a.m. - 6:30 p.m. (CST) Saturday

Tax (add state and local taxes as required by law)

Postage and Handling Charge (Within the U.S.A.)

$5.50

Method of Payment (No C.O.D.s)

Check or money order (payable to The Eureka Company). Do not send currency.

TOTAL ENCLOSED

Visa (16 digits)

DiscoverCard (15 digits) MasterCard (13 digits)

American Express (15 digits)

Acct. number

Expiration date

© 2003 White Consolidated Ltd.

_____________________________________________

	1
	-
and	800
	-
4:45
	438
p	-
.	7352*

m

.

,

Signature (Full name as shown on account)

Dust

Cup

Filter

61882

2

.

99

Printed in China