Equipment Registration

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Purchaser Information

Name*

Address*

Street Address Address Line 2 City State Zipcode Country

Email*

Phone*

Dealer Information

Dealer Name*

Salesman Name*

Salesman Email

Equipment

Delivery Date*

MM slash DD slash YYYY

Model*

Serial Number*

I (Purchaser) hereby acknowledge:

Delivery Acceptance*

That I have received and accepted delivery of the equipment above described.*

Equipment Check*

That the equipment was checked thoroughly for loose or missing parts and has been adjusted in accordance with the Dealer-to-Purchaser Checklist (see Operator’s Manual).*

Safety Instructions*

That I have read carefully the Operator’s Manual, Including specifically the Safety Instructions.*

Procedures*

That I have been advised of the proper procedures for operating, maintaining and lubricating this equipment.*

Operator's Manual*

That I have been instructed on and do understand the application, limitations, and capacities this equipment was designed and recommended for, all as described in the Operator’s Manual and in other literature published by Pickett Equipment.*

Warranty Disclaimers*

That I have read and understand the nature and extent of the Warranty Disclaimers and I understand clearly that there were and are no other representations or warranties, either express or implied, made by anyone*

Warranty Registration*

That this Warranty Registration Information has been completed by the purchaser of the above listed equipment.*

Equipment Registration

Purchaser Information

Dealer Information

Equipment

I (Purchaser) hereby acknowledge:

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