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Please include a copy of your original receipt along with this completed Parts Order Form and either:
Mail to: Ashley Furniture Industries, Inc.
Parts Dept. / Corporate Building
One Ashley Way
Arcadia, WI 54612 (or)
Email to: PartsDept@ashleyfurniture.com (or)
Fax to: 800-477-0103
FIELDS MARKED WITH AN ASTERISK (*) ARE REQUIRED TO COMPLETE YOUR ORDER
*Your Name_____________________________*Daytime Phone:________________________________
*Address:_______________________________ Home Phone:___________________________________
_______________________________________ Cell Phone:____________________________________
_______________________________________ Email:________________________________________
*City:_____________________*State:________
*Zip Code:_________________
Model #: 2450425 *Serial #:___________________________(Found under unit)
Purchased from:___________________________ *Date of Purchase:______________________________
Reason for Parts Order (Circle One):
Missing Part(s)
Parts Requested:
Part
Replacement Part
Number
1
2450425031
2
3
807262CRP
4
807280CRP
5
809785C12RP
Customer Service 866-319-0809
Servicio al Cliente 866-319-0809
www.berkline.com
REPLACEMENT PARTS ORDER FORM
Scratched
Number
73867
Broken
Description
CHAISE PAD CASING
DECORATIVE BRAD
POLY BACK CUSHION
POLY FRONT SEAT CUSHION
POLY SEAT CHAISE CUSHION
Quantity
Page 6 of 12
MRP 79204
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