Eureka 50 warranty Order Form

		The Eureka Company					10/01
						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 al 5670-6169

By Mail

Simply fill out this

Order Form.

Please be sure to

include day and evening phone numbers.

71891

__________________
Model Number				Genuine Eureka Parts
__________________						Filter Assembly	61811	1.99
Type
__________________
Serial Number						Large Brush	61809	1.99
	IMPORTANT:					Small Brush	61810	1.79
Be sure to include
your model, type, and						Strap	61812	2.99
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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Printed in China

Hose

Assembly

	Part
61808
	No
	.
	Qty
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4Price

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99(USD) Total