Terex Aerial Work Platforms, 18340 NE 76th Street Redmond WA 98052, Ph: 800-536-1800, 425-881-1800
Safety Notice 120013
New Owner Update Form
(for updating machine owner information only)
Genie and ANSI requires that the seller of a Genie machine report to Genie the model and serial number of
each machine sold, as well as the name, address, and telephone number of the new owner, within 60 days of
the sale.
•
If you have sold a machine, list the complete model and serial number (examples: GS3211A-110003 or
GS3212A-111915 or GS4612A-110290) and the name, address and phone number of the new owner.
New Owner Information:
Machine 1
Machine 2
Machine 3
Model*
Serial Number*
Owner Name*
Address 1*
Address 2
City/State/Zip*
Phone Number*
Contact Person
*
Required fields.
Seller Information:
Date:
Company Name:
Account #:
Address:
(street)
(city)
State, zip code
Phone #:
•
List any machines that could not be inspected or repaired because of the following
:
Model & Serial Number
Scrapped
Exported
Stolen
Others (explain)
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Fax to:
United States
877-738-7530
Canada
425-498-7530
All
other
locations
001-425-498-7530
