Name
Address
City Country
State/Prov Zip/Postal
Phone
Date of Purchase
Type of Lock:
❑
SecuRam
™
Electronic Lock
Please choose one option:
❑
2 years—
$29.99
❑
4 years—
$59.99
Card Information:
❑
VISA
❑
Mastercard
❑
Discover
❑
AMEX
Cardholder Name:
Card Number:
Exp. Date: 3
-
digit Security Code:
Signature:
EXTENDED LOCK WARRANTY PURCHASE FORM
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To purchase the Extended Lock Warranty, visit www.rhinosafe.com or cut this purchase
form along dotted line, complete and return by mail, along with a copy of the original
purchase receipt, to:
Orders Department
Rhino Metals, Inc.
607 Garber Street
Caldwell, Idaho 83605
Model Number
Serial Number
❑
Check box if you prefer not to receive our newsletter.
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Summary of Contents for Longhorn LSB1014
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