65 66
Replacement Parts Order
Form
Co
m
plete the for
m
below. Your
m
odel nu
m
ber with
color code and
m
anufacturer date code M
U
S
T be
included on the for
m
to ensure proper replace
m
ent
parts. Your
m
odel nu
m
ber with color code and the
date code can be found on a sticker on the side of
child restraint. Pay
m
ent in
U
.
S
. dollars
m
ust
a cco
m
pany your order. Choose parts n eede d fro
m
the
list on the ba ck page.
R
eturn the for
m
with pa y
m
ent to:
D
o
r
e
l
Juv
e
n
il
e
Gr
o
up
,
I
n
c
.
C
o
nsum
e
r
R
e
l
a
t
i
o
ns
D
e
p
a
r
t
m
e
n
t
P
.
O
.
B
o
x
2609
C
o
l
umbus
,
I
N
47202
-
2609
Fax orders to: 1-800-207-8182
Please
m
a ke
m
oney orders payable to
D
orel Juvenile
G
roup, Inc. Fill in the area below to charge to Visa or
Mastercard.
W
e do not accept personal checks or
D
iscover Card. All outsid e of
U
.
S
. and Canada M
U
S
T
use credit ca rd.
W
e
M
U
S
T
h
a
v
e
t
h
i
s
i
n
f
o
rm
a
t
i
o
n
t
o
pr
o
ce
ss
y
o
ur
o
rd
e
r
:
M
o
d
e
l
Numb
e
r
(
5
d
i
g
i
t
s
&
3
l
e
tt
e
rs)
:
________
M
a
nu
f
a
c
t
ur
e
D
a
t
e
(mm/dd/yyyy)
:
__________
S
hip To
(
Please Print
)
: ______________________
N
a
m
e: ________________________________
Address:________________________________
City: __________________________________
S
tate/Province:_______________
Z
ip ________
Tele phone: ______________________________
E
m
a il Address: __________________________
