TO ORDER BY PHONE, PLEASE CALL:
1-877-207-0923 between 7 a.m. an d 8 p.m.
Cen tral 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
IM PORTANT: Be sure to in clude your model, type, an d serial number. These numbers may be found on th e rating plate.
MODEL NUMBER: ____________________ TYPE: ____________ SERIAL NUMBER: ______________________
Part Number Qty. Price ( USD) Total
ACCESSORIES/ TOOLS:
Uph olstery Nozzle with Bristles 61754 7.99
Uph olstery Nozzle with Sponge 61755 8.49
Hose Assembly 61758 33.99
MISCELLANEOUS PARTS:
Brush Roll 61759 10.99
Belt 61760 1.99
Clean Water Solution Tank 61761 17.99
Tank Cap 61762 1.49
Recovery Tan k 61763 29.99
Filter Package ( Reservoir & Basket Filters) 61764 2.49
Carpet/ Floor Suction Cover 61765 5.49
Rotor Knob 61766 1.99
Boot Seal with Plunger 61756 .99
Rear Wheel Replacemen t Kit (wheels, axles, clips) 61757 3.99
Prin ted in U.S.A.
71727
BY MAIL: Simply fill out th is form and mail to ad dress above. Please include day an d even in g phon e n umbers
Method of Paymen t:
Check or Money Order (payable to Authorized Appliance Parts)
Month
Exp. Date:
_
Year
Signatu re ( full n ame as sh own on acct.) _____________________________________________
TOTAL (prices subject to ch ange without notice)
TAX ( add state tax & local taxes as required by law)
PO STAGE & HANDLING CHARGE (with in U.S.A.)
TOTAL
( please n o cash or C.O.D.s)
$5.50
AUTHORIZED APPLIANCE PARTS
P.O. BOX 2799, BLOOMINGTON, IL 61702-2799
8/ 01
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