Eddie Bauer Luxe, Elite, 3-In-1, 4358-3340D manual Replacement Parts Order Form, Fax orders to

4358-3340D Elite_Lux 3/13/06 3:08 PM Page 55

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Replacement Parts Order Form

Complete the form below. Your model number with color code and manufacturer date code MUST be included on the form to ensure proper replacement parts. Your model number with color code and the date code can be found on a sticker on the side of child restraint. Payment in U.S. dollars must accompany your order. Choose parts needed from the list on the next page

.

Return the form with payment to:

Dorel Juvenile Group, Inc.

Consumer Relations Department

P.O. Box 2609

Columbus, IN 47202-2609

Fax orders to: 1-800-207-8182

Please make money orders payable to Dorel Juvenile Group, Inc. Fill in the area below to charge to Visa or Mastercard. We do not accept personal checks or Discover Card. All outside of U.S. and Canada MUST use credit card.

Ship To (Please Print):________________________________

Name: ____________________________________________

Address: __________________________________________

City: ____________________________________________

State/Province: __________________________Zip ________

Telephone: ________________________________________

Email Address: ____________________________________

We MUST have this information

to process your order:

Model Number (5 digits & 3 letters): ______________

Manufacture Date (mm/dd/yyyy): __________________

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