Warranty Registration Form
Date of Purchase
...........................................................................
Name
...........................................................................
Company
...........................................................................
Address
...........................................................................
..................................................
Tel No (
) ............................
E-mail
...........................................................................
The following information is vital for your warranty
Please make sure it's correct and complete.
Serial No
...........................................................................
Model
...........................................................................
Product Type:
PC Card
Internal
I intend to use this modem at:
Home
Business
Dealer's Name
...........................................................................
Dealer's Address
...........................................................................
..................................................
Tel No (
) ............................
How did you find out about our products?
..................................................................................................................
..................................................................................................................
Post Code
............................
Fax No (
)
..........................
External
Other
School/College/University
Government Office
Post Code
............................
Fax No (
)
..........................
!
Make sure
you fill this
section in!