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AUTHORIZED APPLIANCE PARTS
P.O. Box 2799, Bloomington, IL 61702-2799
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Name
Address (street address needed for UPS)
City State Zip
Telephone (Day) (Eve) (Fax)
Name
Address (street address needed for UPS)
City State Zip
Telephone (Day) (Eve) (Fax)
__________________
Model Number
__________________
Type
__________________
Serial Number
IMPORTANT:
Be sure to include your model,
type, and serial numbers.
These numbers may be
found on the rating plate.
To Answer Problems or
Questions for U.S.A. and
Canada call:
1-800-282-2886*
7 a.m. to 8 p.m. central standard
time Monday through Saturday
Part No. Qty. Price (USD) Total
Corona Wire 61915 9.99
Electrostatic Paper Filter EF100 49.99
Carbon Filter EF101 24.99
Total (prices subject to change without notice)
Tax (add state and local taxes as required by law)
Postage and Handling Charge (Within the U.S.A.)
TOTAL
© 2002 White Consolidated Ltd.
Printed in Sweden
Method of Payment (No C.O.D.s)
Check or money order (payable to The Eureka Company). Do not send currency.
Charge to my Visa (13/16 digits) MasterCard (13 digits) American Express (15 digits)
Acct. number Expiration date
Signature (Full name as shown on account) _____________________________________________
72584
To Order
By Phone
1-800-
438-7352*
HOURS:
Call between 8 a.m.
and 4:45 p.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.
$5.50
✃
ORDER FORM
09/02
(Not applicable in Canada)