Air-O-Fan Dealer Network
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Customer Info
Dealer *
Sprayer Serial# *
Engine Serial#
Company Name
Customer First Name
Customer Last Name
Customer Address*
Customer Address2
Customer Zip Code *
Customer City *
Customer State *
Customer Phone
Customer Email
Customer Signature *
Dealer Signature *
Delivery Date *
Dealer Inspection
Safety
    Required Field*

    You agree that the Name and/or ID shown above fully, accurately and uniquely identifies you in our database. You furthermore agree that the customer taking delivery of the sprayer shall sign their name in the appropriate entry field, the dealer shall sign their name in the appropriate field and your submission of this form, via the "Submit Warranty Registration" button, shall constitute the execution of this document in exactly the same manner as if you had signed, by hand, a paper version of this agreement.