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I have received the previous information (Name of Operator)
Name of Company
I Certify this report to be accurate (Name of Start-Up person)
Employed by
Date and Time of Start-Up
Present at Start-Up:
( ) Engineer
( ) Contractor
To be filled out by factory:
Start - Up form checked by:
Date:
Date:
( ) Operator
( ) Other
Date warranty registration mailed:
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