Replacement Parts Order Form - DJG Alpha Omega Instruction Manual

4358-5356 US All in One 7/26/10
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Replacement Parts Order Form

Complete the form below. Your model number with color
code and manufacturer date code MUST be included on the
form to ensure proper replacement parts. Your model number
with color code and the date code can be found on a sticker
on the side of child restraint. Payment in U.S. dollars must
accompany your order. Choose parts needed from the list on
next page.
Return the form with payment to:
Dorel Juvenile Group, Inc.
Consumer Relations Department
P .O. Box 2609
Columbus, IN 47202-2609
Fax orders to: 1-800-207-8182
Please make money orders payable to Dorel Juvenile Group,
Inc. Fill in the area below to charge to Visa or Mastercard. We
do not accept personal checks or Discover Card. All outside
of U.S. and Canada MUST use credit card.
Ship To (Please Print): ____________________________
Name: ________________________________________
Address: ______________________________________
City: ________________________________________
State/Province: ____________________Zip ________
Telephone: ____________________________________
Email Address: __________________________________
We MUST have this information to process your
order:
Model Number (5 digits & 3 letters): ______________
Manufacture Date (mm/dd/yyyy): ________________
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