Stove Warranty Registration Form

 

Customer information:

 

First Name:

 

Last Name:

 

Address 1:

 

Address 2:

 

City:

 

State:

 

Zip Code:

 

Phone Number:

 

Cell Phone

 

Fax Number:

 

Email Address:

 

Stove Purchase Information:

 

Stove Model: Select a stove model from list Auger Feed 140 Channing III Kast Console III Liberty Model 140 Other

 

Model (if 'other'):

 

Stove Serial Number:

 

Dealer Name:

 

Order/Invoice number:

 

Manufacturer Date:

 

Purchase Date: