BILS-10003 rev E
46
Warranty Registration Form
Fax or mail this form to activate your warranty
Serial Number
____________________________________
Installation Date ____________________
Month / Date / Year
Contact Person ___________________________________
Company
____________________________________
Street Address
____________________________________
____________________________________
City
____________________________________
State
____________________________________
Zip Code
____________________________________
Phone Number
____________________________________
Ext.
Type of Business ______________________________________
Load Equipment ______________________________________
Manufacturer Model Voltage VA
______________________________________
______________________________________
______________________________________
______________________________________
______________________________________
______________________________________
Fax to:
(608) 565-5879
Fold in half and tape – DO NOT STAPLE