Customer Order Form - Eureka Atlantis Express 2550 Series Owner's Manual

MODEL
NUMBER
SOLD TO:
Name
Address
City State
Telephone (Day)
Telephone (Eve)
Fax
SHIP TO:
Name
Address
City State
Telephone (Day)
Telephone (Eve)
Fax
PAYMENT (no C.O.D. Orders)
Check or money order. Do not send currency.
Payable to Electrolux Home Care Products North America
VISA DC MC
ACCT. NUMBER
SIGNATURE (full name as shown on acct.)
TO ORDER:
By Phone: 1-800-282-2886
Hours: Call Monday-Friday
8:00 am - 7:30 pm CST;
Saturday 10:00 am - 6:30 pm CST
(Please call the same number for
answers to problems or questions
in the USA and Canada)
En Mexico llame al:
(55) 5343-4384
By FAX: 1-309-589-7583
By Mail:
Simply fill out this Order Form.
Please be sure to include day and
evening phone numbers.
ONLINE
www.eureka.com
74763
(12/04)
TYPE SERIAL
NUMBER
Genuine Eureka Parts
Zip
Zip
AMEX
EXPIRATION
DATE
TOTAL
TAX
POSTAGE & HANDLING CHARGE
T O T A L
WATER TANK ASSEMBLY
RECOVERY TANK ASSEMBLY
NOZZLE ASSEMBLY
NOZZLE BRISTLE STRIP
DETERGENT TANK ASSEMBLY
32 OZ. CARPET & UPHOLSTERY
SHAMPOO
64 OZ. CARPET & UPHOLSTERY
SHAMPOO
(*prices subject to change without notice)
(add state tax & local taxes as required by law)
E N C L O S E D
© 2004 Electrolux Home Care Products Ltd.
The Eureka Company
P.O. Box 3900 • Peoria, IL 61612
IMPORTANT: Be sure to include your model, type, and serial
numbers. These numbers may be found on the rating plate.
Part No.
74730
74409
74418
74747-355N
74430
62383
60170A
(within USA)
Qty. Price Total
(USD)*
17.99
27.99
14.99
3.99
5.99
5.99
10.99
$5.50
Printed In China