Warranty Registration

Extended Warranty Registration
Name:*

First NameLast Name
E-mail:*
example@example.com
Phone Number:*
Address: *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
VEHICLE INFORMATION
Vehicle Year*
Vehicle Make*
Vehicle Model*
Vehicle Milage:
Annual Mileage:
PRODUCT INFORMATION

(Must complete separate form for multiple products)
Product Name:*
Place of Purchase:*
Proof of Purchase:*

Valid receipt from point of purchase.
Cancelof
Date of Purchase:*

MonthDayYear
Eligible Products include the following:
- Stocker Star Part Number Prefix: TN, TS, TD
- Proma Star Shocks Part Number Prefix: DS, DD, GS, GD, MS, MD
- Proma Star Struts Part Number Previx: HS0, HD0
- Ultra Ride Part Number Prefix: US
- Aluma Matic Part Number Prefix: ALN
Part Number:*
Serial Number:*
Serial Numbers for Part #1 - 9 digit number
Serial Number:
Serial Numbers for Part #1 - 9 digit number
Serial Number:
Serial Numbers for Part #1 - 9 digit number
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Should be Empty:

Extended Warranty Registration