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Model No. | Serial No. |
(Both Numbers Required) |
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SHIP
TO:
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Name
Address
Check or money order enclosed (payable to Century Products)
Charge to credit card
Visa MasterCard
Discover
Account #
City, State, Zip Code
Expiration date
Telephone (including Area Code) | Signature |
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Subtotal:
Fabric Seat Pad with Comfort Clips® | ......................$35.00 |
Armrest Pads (2) | $10.00 |
Shield with Harness Straps | $16.00 |
Tongues (2) | $5.00 |
Harness Strap | $5.00 |
Buckle and Crotch Strap | $10.00 |
Metal Rod for Crotch Strap | $5.00 |
$5.00 | |
Locking Clip (All models) | $5.00 |
LATCH Belt | $20.00 |
Tether System | $10.00 |
Instruction Manual (All models) | FREE |
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Shipping
&handling*: $5.00 Sales tax**:
Total:
*$15.00 outside the continental U.S.
**CA 7.25%, IL 6.25%, IN 5%, NY 8.25%, OH 5.75%, PA 6%, SC 5%
MAIL ORDER TO: 
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CENTURY PRODUCTS
P.O. BOX 100
ELVERSON, PA
ATTN: CUSTOMER SERVICE DEPARTMENT
OR FAX ORDER TO:
(610)
37