Eureka 790 warranty Order Form, $5.50, Total Enclosed, Eureka, Parts, Genuine

	The Eureka Company	4/03
		ORDER FORM
VACUUM CLEANERS	P.O. Box 2799
	Bloomington, IL 61702-2799
		(Not applicable in Canada)

S O L D

T O

Name

Address (street address needed for UPS)

City	State	Zip
Telephone (Day)	(Eve)	(Fax)

S H I P

T O

Name

Address (street address needed for UPS)

City	State	Zip
Telephone (Day)	(Eve)	(Fax)

To Order

By Phone

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.

ON-LINE

www.eureka.com

72807

__________________

Model Number

Disposable Bag (Style SL) - pkg of 3

61125

3.49

__________________

Belt

61121

2.39

Motor Filter

61123

1.49

Type

__________________

Exhaust Filter

61124

1.99

Serial Number

Brush Roll

61128-1

17.49

IMPORTANT:

Hose Assembly

61129-1

16.49

Be sure to include

Dusting Brush

61126

1.99

your model, type, and

Nested Wands

61127

3.99

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.

8 a.m. - 7:30 p.m. (CST) Monday - Friday and 10 a.m. - 6:30 p.m. (CST) 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.)

$5.50

Check or money order (payable to The Eureka Company). Do not send currency.

TOTAL ENCLOSED

Visa (16 digits)

DiscoverCard (15 digits) MasterCard (13 digits)

American Express (15 digits)

Acct. number

Expiration date

_____________________________________________

© 2003 White Consolidated Ltd.

	1
	-
and	800
	-
4:45
	438
p	-
.	7352*
m
.
,
Signature
(Full
name
as
shown
on	Genuine
account)
Dust
Cup	Eureka
Filter
	Parts

	Part
61975
	No
	.
	Qty
	.
.	Price
9
99
	(USD)
Printed
in
	Total
China