At-Home Services
Iron Service & Parts Order Form
Date_________________________________

Name________________________________

Company Name________________________

Shipping Address_______________________

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Daytime Phone_________________________

Evening Phone_________________________

Cell Phone____________________________

Email Address_________________________
Items Enclosed
Quantity
(of similar items)
Description
(type, model, brand, etc.)
Service Requested
(problem type, serviced, repaired, etc.)
     
     
     
     
Special Instructions

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___________________________________________________________________________________________________

___________________________________________________________________________________________________

___________________________________________________________________________________________________

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Please properly package, insure, & ship your order (along with this form) to:

At-Home Services
532 Washington Street NE
Albuquerque NM 87108

Upon completion of work, you will receive email (or phone) notification detailing the total cost of your order and
payment options. All orders will be shipped promptly upon receipt of payment.
Toll free phone & Email
877-853-1446
at-home-services@comcast.net
Quantity
Item Description
Part #
Price
Total
  Filter Resin
     
  Naomoto Thermostat
     
  Sussman Thermostat
     
  Pacific Steam Thermostat
     
  Fit-All Teflon Shoe
     
  Gravity Feed Water Bottle
     
  Gravity Feed Water Line
     
         
         
         
         
 
Total
 
New Mexico Residents Only, Add 6.875%
Sales Tax
 
No Additional Shipping If Included With Iron Service Above
Orders $10.00 or less, $5.00 Shipping & Handling
Orders $10.00-$35.00, $8.00 Shipping & Handling
Orders over $35.00, Free Shipping!
Shipping&
Handling
 
Send Check/Money In this Amount To The Address Below
Grand Total
 
Steam Iron Parts & Supplies (Can be ordered separately or included with iron order above)
Do not fill in, At-Home Services use only.
Date
Received
Inventory
Availability          Yes          No
Date
Processed
Date
Shipped