Purchaser Information*
I. Purchased By (Name)
II. Address
III. City
_______________________State________Zip Code
IV. Telephone Number
V. Email Address
Dealer Information*
VI. Purchased From
VII. Address
VIII. City_______________________ State________ Zip Code
Unit Information*
IX. Model Number_____________________ Purchase Date
X. Purchase Price
XI. Serial Number_____________________ Mfg. Date
Purchase Questions
How did you first hear about our product? (Please check one)
Word of Mouth ____
Other:
________________________________________________________
Where did you receive information about our product?
Via Telephone____
Other: ________________________________________________________
* Required Information
IMPORTANT! READ AND FOLLOW ALL INSTALLATION AND MAINTENANCE INSTRUCTIONS, INCLUDING CLEANING THE UNIT AS SPECIFIED, AND
ENGLAND'S STOVE WORKS IS NOT RESPONSIBLE FOR ANY DAMAGE OR INJURY INCURRED DUE TO NEGLECT, OR DUE TO UNSAFE INSTALLATION OR
WARRANTY REGISTRATION for England's Stove Works®
_________________________________________
____________________________________________________
___________________________________________
_______________________________________________
_____________________________________________
___________________________________________________
_____________________
Burn Trailer Demonstration____
Dealer (Name of dealer) ___________
REPLACING GASKETS ANNUALLY, AND PARTS AS NEEDED.
USAGE OF THIS PRODUCT. CALL TECHNICAL SUPPORT WITH ANY QUESTIONS.
____________
_____________
_________________
Internet____
Internet____
63
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