Motor Home (Coach): Year _________ Model ___________________ Serial _____________
Chassis: Make ___________________ Serial (VIN) ______________
Air Conditioner:Brand
Furnace:
Water Heater:
Power Converter:
110-Volt Generator:
Range
Microwave Oven:
Refrigerator
Television:
Video Cassette Player:
Dealer
Name _______________________________________________________________________
Address______________________________________________________________________
____________________________________________________________________________
Phone _______________________________________________________________________
INSURANCE POLICY
Company ____________________________________________________________________
Policy Number ________________________________________________________________
Phone _______________________________________________________________________
IMPORTANT
SERIAL NUMBERS
Model ___________ Serial _ __________________
Brand ___________ Model ____________ Serial _ ___________
Brand ___________ Model ____________ Serial _ ___________
Brand ___________ Model ____________ Serial _ ___________
Brand ___________ Model ____________ Serial ___________
Brand ___________ Model ____________ Serial _ ___________
Brand ___________ Model ____________ Serial _ ___________
Brand ___________ Model ____________ Serial _ ___________
Brand ___________ Model ____________ Serial _ ___________
Brand ___________ Model ____________ Serial _ ___________
EMERGENCY INFORMATION