P P- A D P- 7
AC Home Adapter
1
$ 1 0 . 0 0
N a m e
A d d r e s s
C i t y
S t a t e
Zip Code
Phone Number
( )
Optional & Replacement Parts Order Fo r m
OPTIONAL PART DESCRIPTION
Q UA N T I T Y
C O S T
Mail To :
H o M e d i c s
Service Center Dept. 168
3000 Pontiac Trail
Commerce Township, MI 48390
Detach and return order form with check or money order payable to
HoMedics, Inc. Please allow 2 to 4 weeks for delivery.
You can also phone in your order at 1-800-466-3342
S U B T O TA L
TA X-Michigan Residents add 6%
To t a l
P P- A D P- C A R
12V Auto Adapter
1
$ 5 . 0 0
REPLACEMENT PART DESCRIPTION
Q UA N T I T Y
C O S T
BK4500 IB 3/30/05 1:22 PM Page 9
