Eureka 78A warranty Order Form

		2/01
	The Eureka Company	ORDER FORM
	P.O. Box 2799
VACUUM CLEANERS	Bloomington, IL 61702-2799	(Not applicable in Canada)

S	Name			S	Name
O				H
L	Address (street address needed for UPS)			I	Address (street address needed for UPS)
D				P
	City	State	Zip		City	State		Zip
T				T
	Telephone (Day)	(Eve)	(Fax)		Telephone (Day)	(Eve)		(Fax)
O				O
		__________________				Part No.	Qty.	Price (USD)	Total
		Model Number:

1-800-438-7352*

HOURS:

Call between 8 a.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.

__________________	Genuine Eureka Parts
Type:	Charger	60683-1	6.89
__________________
Serial Number:
IMPORTANT:	Motor Filter	60684	1.39
Be sure to include
	Filter Support, only	60685	2.69
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. Orders)		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)

www.eureka.com	Acct. number	Expiration date
59754		_____________________________________________
		Printed in U.S.A.

Signature (Full name as shown on account)

©

2001 White Consolidated Industries,

Inc

.

and
	By	To
4:45	Phone
,		Order
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Battery

60798

10

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