Model No.

Manufactured in

(Both Numbers Required)

SHIP TO:

Name

Address

City, State, Zip Code

Telephone (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

Harness

Visa

MasterCard

Discover

Harness clip

 

Locking clip

 

Account #

Head support

 

Base w/LATCH

 

Expiration date

LATCH

 

 

 

 

Signature

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

Exton, PA 19341

39

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Graco ISPA003AA manual Ship to, Exton, PA