Product/Warranty Registration Form

Product/Warranty Registration Form
Submission of this form is required for all new machines purchased through Valley Tool and Manufacturing at the time of sale to the end user. All information is required, including an electronic copy of the Bill of Sale.

This form serves as a record of sale for any equipment currently stocked at dealership locations or new units purchased for immediate sale. It also serves as warranty registration for the equipment being purchased. If this form is not fully completed and submitted, the equipment being purchased will not be eligible for warranty services.

Completion of this form is an acknowledgement that a dealer representative was present when the attachment was delivered and that the "Delivery Report Form" (found in owner's manual) was completed.
End User Information
Customer Name*

First NameLast Name
Customer Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Customer Email*
example@example.com
Dealership Information
Dealership Name*
Salesperson Name*

First NameLast Name
Dealership City/State*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Product Information
Date of Sale*

MonthDayYear
Date
Brand Sold*
Vrisimo Model Sold*
BrushHound Model Sold*
RockHound Model Sold*
Flowcore Model Sold*
Serial Number of Attachment*
Power Unit Year*
i.e. Caterpillar, Kubota, etc.
Power Unit Make*
i.e. Caterpillar, Kubota, etc.
Power Unit Model*
i.e. 305E2, KX040, etc.
Indicate Use Type:

Construction UseAgricultural UseAgricultural UseRental
Electronic Copy of Bill of Sale

Browse Files

Cancelof
Should be Empty:

Product/Warranty Registration Form

End User Information

Dealership Information

Product Information