Tri Lynx Levelers

TO OBTAIN WARRANTY COVERAGE COMPLETE THIS FORM AND SUBMIT IT WITHIN 6 WEEKS OF ORIGINAL PURCHASE. ALL INFORMATION SUPPLIED IS STRICTLY CONFIDENTIAL AND NOT FOR RELEASE.

First Name: Last Name:

Address:

City: State/Province: Zip/Postal Code:

Email Address:
(Please provide an email address for your warranty registration)

Check this box if you would like to receive email announcements about new products or services from our company
(note: we will NEVER share or sell your email address to anyone). Please remember to include your email address in the space provided.

Purchase Date: (D) / (M) / (Y)

Select Product(s):
10-pack 4-pack Stop N'Chock Cap Pack Stay-Put Hanger Stay-put Plug Holder	Reason: Gift Own Use Other

How did you hear about our product?

Where did you purchase the LYNX LEVELERS?	RV Dealer Online Mail Order Walmart other
	Other

*Required field: I have read and understand the detailed instructions and safety warnings for LYNX LEVELERS.

Thank you!

U.S. Patent #5,328,154 Patent #5,328,154 Patent #5,458,315 CDN Patent #2,081,996