Warranty - Thermalux

Name*

First Last

Address*

Street Address City

State*

Zip Code / Post Code*

Phone*

Fax

Email*

INSTALLATION COMPANY INFORMATION

Installation Type*

Residence Type*

Application Type

Company Name

Address

Address Line 2 City State / Province / Region ZIP / Postal Code

Installer Name

First

License Number

Phone

Fax

Place of Purchase

please note the following to assist you in warranty registration

For help locating the serial number view this illustration

Serial Number*

Example format (YYYY.XX-XXXXXX)

Model Number*

If your model contains a GQ-XXXXXX number please select the matching GQ option.

Gas Type*

Date of Install*