REPLACEMENT PARTS ORDER FORM

Total Parts

$

Sales Tax

$

Shipping & Handling

$

Outside Continental USA

$

Total

$

We must have this information to process your order: see label on bottom tubing of Playard.

Model No.:

Manufacture Date:

Sales Tax

California, Illinois, Indiana, Maryland and New York Residents Add Sales & Applicable Local Taxes

Ohio Residents Add 5.75% Sales Tax

Pennsylvania Residents Add 6% Sales Tax except for Philadelphia and Allegheny Counties add 7% Sales Tax

South Carolina Residents Add 5% Sales Tax

Shipping & Handling

 

 

 

US $

0.01 to $

9.99

=

US $ 3.00

(CAN $

0.01 to $

15.49

=

CAN $ 4.75)

 

US $ 10.00 and over

=

US $ 5.00

(CAN $ 15.50 and over

=

CAN $ 7.75)

Outside Continental USA

 

 

Add:

US $ 10.00

 

 

 

 

(CAN $ 15.50)

 

 

 

Please make checks payable to CENTURY PRODUCTS or charge to VISA, MASTERCARD or DISCOVER.

Orders outside USA Must use credit card.

Cardholder’s Name:

Card Number:

Card Exp. Date:

Check enclosed for $

NOTE: If requested color is not available, a similar color will be substituted.

SHIP TO:

Name:

Address:

City:

State:Zip:

Telephone No.:(

)

 

 

 

MAIL BOTH PAGES OF ORDER TO:

CENTURY PRODUCTS

P.O. BOX 100

ELVERSON, PA 19520-9974

ATTENTION: CUSTOMER SERVICE DEPARTMENT

FAX BOTH PAGES OF ORDER TO:

(610) 286-4555

PM-1647AA 6/00

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Century PM-1647AA instruction manual Replacement Parts Order Form, Model No Manufacture Date