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Replacement Parts Order Form
Complete the form. Your model number and manufacturer date
code
MUST
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 pay-
ment to:
Dorel Juvenile Group, Inc.
Consumer Care Department
P.O. Box 2609
Columbus, IN 47202-2609
Please make money orders payable to Dorel Juvenile Group, Inc. Fill
in the area on the next page to charge 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
MUST
use credit card.
Ship To:
(Please Print)
Name:
_______________________________________
Address:
_____________________________________
City:
_________________________________________
State/Province:
_______________
Zip:
_______________
Telephone:
___________________________________
Email Address:
________________________________
We
MUST
have this information:
Model Number (8 to 9 characters)
:_________________
Manufacture Date (mm/dd/yyyy)
:__________________