Eureka 50 Series warranty Order Form

		The Eureka Company					4/01
						ORDER FORM
		P.O. Box 2799
VACUUM CLEANERS		Bloomington, IL 61702-2799
							(Not applicable in Canada)
S	Name			S	Name
O				H
	Address (street address needed for UPS)				Address (street address needed for UPS)
L				I
D				P
	City	State	Zip		City	State	Zip
T				T
	Telephone (Day)	(Eve)	(Fax)		Telephone (Day)	(Eve)	(Fax)
O				O

To Order

By Phone

438-7352*

HOURS:

and 4:45 p.m.

central standard time

Monday through Friday.

By FAX

1-309-823-5789

*En Mexico

Llame 5670-6169

By Mail

Simply fill out this

Order Form.

Please be sure to

include day and evening phone numbers.

70320

__________________
Model Number				Genuine Eureka Parts
__________________					Filter		53820	3.29
Type
__________________
Serial Number					Brush Roll		53815	20.79
	IMPORTANT:				Belt - pkg of 2		53819	2.49
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.
			7 a.m. to 8 p.m. central standard time Monday through Saturday				Tax (add state and local taxes as required by law)
Method of Payment (No C.O.D.s)							Postage and Handling Charge (Within the U.S.A.)		$3.75
	Check or money order (payable to The Eureka Company). Do not send currency.
								TOTAL
	Charge to my Visa (13/16 digits)				MasterCard (13 digits) American Express (15 digits)
Acct. number						Expiration date

© 2001 White Consolidated Industries, Inc.

_____________________________________________

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Signature
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account)

Printed in China

Filter

Support

14329
1	Part
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	Qty
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	Price
2	(USD)
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29
	Total