Customer order form, Authorized appliance parts – GE 71337 User Manual

Page 9

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TO ORDER BY PHONE, PLEASE CALL:
1-877-207-0923 between 7 a.m. and 8 p.m.
Central Standard Time, Monday - Friday
or FAX to 1-309-823-5789.

S

O

L

D

T

O

S

H

I

P

T

O

NAME

ADDRESS (street address needed for UPS)

CITY

STATE

ZIP

DAYTIME PHONE

EVENING PHONE

FAX

E-MAIL

NAME

ADDRESS (street address needed for UPS)

CITY

STATE

ZIP

DAYTIME PHONE

EVENING PHONE

FAX

E-MAIL

IMPORTANT: Be sure to include your model, type, and serial number. These numbers may be found on the rating plate.

MODEL NUMBER: ____________________

TYPE: ____________

SERIAL NUMBER: ______________________

Part Number

Qty.

Price (USD)

Total

ACCESSORIES/TOOLS:

Filter Assembly

61518

1.99

Filter Support

61508

.99

Bristle Brush

61511

.99

Dust Cup Assembly

61519

6.99

Front Wheel & Shaft -

package of 2 each

61514

2.49

Crevice Tool

61509

1.49

Printed in China

71340

BY MAIL: Simply fill out this form and mail to address above. Please include day and evening phone numbers

Method of Payment:

Check or Money Order (payable to Authorized Appliance Parts)

Month

Exp. Date:

_

Year

Signature (full name as shown on acct.) _____________________________________________

MasterCard

TOTAL

(prices subject to change without notice)

TAX

(add state tax & local taxes as required by law)

POSTAGE & HANDLING CHARGE

(within U.S.A.)

TOTAL

(please no cash or C.O.D.s)

$5.50

AUTHORIZED APPLIANCE PARTS

P.O. BOX 2799, BLOOMINGTON, IL 61702-2799

2/01

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