Warranty Registration

First Name:*

Last Name:*

Email:*

Re-enter Email:*

Address:*

City:*

State:*

Zip/Post Code:*

Country:*

Vehicle Make and Model:*

Vehicle Year:*

Vehicle Registration Number:*

RustStop® Serial Number:*

RustStop® Model:*
 RS-5 RS-4 RS2000 TCMS

Input Voltage:*
 12 Volts 24 Volts 6 Volts

Anodes (Rust Magnets) Installed:*

Dealer / Store Name:

Dealer / Store Phone Number:

Dealer / Store City:

Dealer / Store State:

Dealer / Store Country:

RRW Number (If Applicable):

Scan/Photo of RRW Form:

Install Date:*