Product Registration Card

Completion and return of this Product Registration Card is necessary in order to receive warranty support.

The information you provide will not be given to anyone outside our company.

What is the Product/s you purchased?_______________________________________________

_______________________________________________________________________________

Serial # (Validator Only):___________________________________________________________

From whom did you purchase this item/s? _____________________Date of Purchase________

What City and State?____________________________________________________________

Your Name_____________________________________________________________________

Company Name_________________________________________________________________

Address _______________________________________________________________________

City/State/Zip__________________________________________________________________

Daytime telephone: ______ - ______ - ________

E-mail:_____________________________

Would you like more information on other products, or product upgrades from Test-Um Inc.? _____