REPLACEMENT PARTS ORDER FORM
Total Parts | $ |
Sales Tax | $ |
Shipping & Handling | $ |
Outside Continental USA | $ |
Total | $ |
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
$ | 0.01 to $ 9.99 = $ | 3.00 |
$ | 10.00 and over = $ | 5.00 |
Outside Continental USA
We must have this information to process your order: see label on leg of stroller.
Model No.:
Manufacture Date:
Please make checks payable in U.S. currency 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 $
Add $10.00
NOTE: If requested color is not available, a similar color will be substituted.
SHIP TO:
Name:
Address:
City:
State:Zip:
Telephone No.:( | ) | |
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|
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MAIL BOTH PAGES OF ORDER TO:
CENTURY PRODUCTS
P.O. BOX 100
ELVERSON, PA.
ATTENTION: CUSTOMER SERVICE DEPARTMENT
or
FAX BOTH PAGES OF ORDER TO:
(610) |
