Automotive Installation Report
Dealer Information:
Dealer _________________________________________________
Address _______________________________________________
City __________________________________________________
State/Zip ______________________________________________
Country _______________________________________________
Phone #_______________________Fax # ____________________
E-mail ________________________________________________
Customer Information:
Customer Name _________________________________________
Address _______________________________________________
City ___________________________________________________
State/Zip _______________________________________________
Country _______________________________________________
Phone #_______________________Fax # ____________________
E-mail _________________________________________________
IMPORTANT NOTICE:
This form will be used for processing warranty claims. Promptly submitting this form is appreciated.
Installation Information: Electronics in Vehicle:
KVH Industries, Inc. • 50 Enterprise Center • Middletown, RI 02842-5279 • U.S.A. • Phone: +1 401 847-3327 • Fax: +1 401 849-0045
Vehicle Make/Model
_________________________
_________________________
______ Number of Satellite Receivers
______ DVD in Vehicle?
______ VHS in Vehicle?
______ Game in Vehicle (XBox, PS2)?
______ Number of Video Displays in Vehicle
System Information:
Components
Serial Number
Location
Installation Date
(KVH or third party)
Block Diagram:
Please provide (on the reverse side of this form in the space provided) a block diagram of the installation indicating the KVH product,
power source, UPS, inverters, multiswitch boxes, satellite receivers and any accessories installed.
(over please)
Please return completed form to:
KVH Industries, Inc., Attn: Warranty Registration, 50 Enterprise Center, Middletown, RI 02842 USA
or fax to 401-849-0045
make
model
Effective January 28, 2005
Subject to change without notice