Replacement Parts Order Form - Cosco SCENERA NEXT Instructions Manual

Replacement Parts Order Form

Complete the form. Your model number and manufacturer date code
be included on the form to ensure proper replacement parts. The codes can
be found on a label on side of child restraint. Payment in U.S. dollars must
accompany your order. Choose parts needed from the list on the 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 on next page to charge to credit card. (Visa or Master-
Card only). We do not accept cash, personal checks, or other credit
cards. All outside of U.S. and Canada
57
4358-6727 Scenera NEXT ENG.indd 56-57 4358-6727 Scenera NEXT ENG.indd 56-57
MUST
MUST use credit card.
Ship To: (Please Print)
Name: ________________________
Address:______________________
City:__________________________
State/Province:__________
Postal Code_____________
Telephone: ____________________
Email Address:
_____________________________
We MUST have this information:
Model Number (8 to 9 characters):
_____________________________
Manufacture Date (yyyy/mm/dd):
_____________________________
Replacement Parts List
NOTE: If requested color is not available,
similar color will be substituted. Prices are
subject to change.
Part Cost Qty Total Cost
Buckle Assembly $7.99 ...___ $_______
Harness Strap $2.99 ...___ $_______
Seat Pad $27.00 .___ $_______
Chest Clip $1.50 ...___ $_______
Tether $6.50 ...___ $_______
UAS $7.99 ...___ $_______
Instructions $0.00 ...___ $_______
Locking Clip $2.50 ...___ $_______
Merchandise Total:............. $_______
Shipping and handling:....... $_______
5/7/15 9:44 AM 5/7/15 9:44 AM
58