Graco ISPA001AF SHIP TO:, Name, Visa, $5.00, LATCH, Total:, Canopy, Address, Model No, Shipping, Seat pad, Subtotal:, Account #, Signature, Canopy bow, MasterCard

Model No. Manufactured in:

(Both Numbers Required)

SHIP TO:

NameAddressCity, State, Zip CodeTelephone (including Area Code)E-mail Address

Subtotal:

Shipping
& handling*:	$5.00

Sales tax**:Total:

*$15.00 outside the continental U.S.

**CA 7.25%, IL 6.25%, IN 5%,

NY 8.25%, OH 5.75%, PA 6%, SC 5%

Seat pad	Check or money order enclosed
Canopy	(payable to Graco Children’s Products Inc.)
Canopy bow	Charge to credit card

3-point harness Visa MasterCard Discover

5-point harness
Harness clip
	Account #
Locking clip
Head support
	Expiration date
Base w/LATCH
LATCH
	Signature

Return the form with payment to: Graco Children’s Products Inc. Customer Service Department 150 Oaklands Blvd.

Exton, PA 19341

45