Order form, Total enclosed, By mail – Eureka 1040 Series User Manual
Page 11
72553
72552
72575-355N
61126
72571
71915-119N
72568
14.99
.99
4.99
2.09
12.99
6.99
8.99
Cloth Dust Bag
Motor Filter
Crevice Wand
Dusting Brush
Hose Assembly
Tool Tray
Supply Cord
Name
Address (street address needed for UPS)
City
State
Zip
Telephone
(Day)
(Eve)
(Fax)
TOTAL ENCLOSED
VACUUM CLEANERS
Name
Address (street address needed for UPS)
City
State
Zip
Telephone
(Day)
(Eve)
(Fax)
S
O
L
D
T
O
S
H
I
P
T
O
72635
© 2002 White Consolidated Ltd.
Printed in China
$5.50
Genuine Eureka Bags and Filters
Accessories/Tools
The Eureka Company
P.O. Box 2799
Bloomington, IL 61702-2799
Part No.
Qty.
Price (USD)
Total
ORDER FORM
12/02
(Not applicable in Canada)
IMPORTANT:
Be sure to include
your model, type,
and serial numbers.
These numbers
may be found on
the rating plate.
Model Number:
Type:
Serial Number:
✃
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
To Answer Problems
or Questions for U.S.A.
and Canada call:
1-800-282-2886*
8 a.m. - 7:30 p.m.
(CST)
Monday - Friday and
10 a.m. - 6:30 p.m.
(CST)
Saturday
*En Mexico llame al
5670-6169
By Mail
Simply fill out
this Order Form.
Please be sure to
include day
and evening
phone numbers.
ON-LINE
www.eureka.com
Method of payment (no C.O.D. orders)
Check or money order
(payable to The Eureka Company). Do not send currency.
Visa (16 digits)
DiscoverCard (15 digits)
MasterCard (13 digits)
Amer. Express (15 digits)
Acct. number
Expiration Date
Signature
(full name as shown on acct.)
Postage & Handling Charge
(within U.S.A.)
Tax
(add state tax & local taxes as required by law)
Total
(prices subject to change without notice)