ENGINE WARRANTY REGISTRATION FORM

This form is required for coverage under the Warranty Guide and it must be completely filled out at the time of start-up. Representatives of the Distributor/Dealer and owner must complete all pertinent information below and sign this form. Signing this form represents acceptance of the unit and that all the information on this form is correct. A copy of this form must be returned to Genrep Ltd. within 60 days of the start-up date. Once received, Genrep Ltd/Ltée will issue the warranty certificate.

Authorized Dealer Performing Startup:

Owner Information:

Name:

Name:

Address:

Address:

City, Prov.:

City, Prov.:

Postal Code:

Postal Code:

Phone #:

Phone #:

Fax #:

Fax #:

Application:
Delivery Date:

Make	Model #	Serial #	HP Rating

Genrep Representative: (Print)

Owner Representative’s Name: (Print)

Signature:

Signature:

Month	Day	Year	Month	Day	Year

□ Toronto – T: 905.502.9950 F: 905.502.9960

□ Ottawa – T: 613.225.9244 F: 613.225.4690

□ Windsor – T: 519.687.6103 F: 519.687.6104

□ Montreal – T: 450.901.0131 F: 450.901.0143

Company

Genrep

2010-05-26

david

Genrep