Warranty Registration

First Name:*

Last Name:*

Email:*

Address:*

City:*

State:*

Zip/Post Code:*

Country:*

Vehicle Make and Model:*

Vehicle Year:*

Vehicle Registration Number:*

RustStop® Serial Number:*

RustStop® Model:*
 RS-5 Standard RS-5 Heavy Duty RS-5 Commercial

Input Voltage:*
 12 Volts 24 Volts 6 Volts

Number of Anodes Installed:*

Purchased from: (e.g. website name, store name, dealer, exhibition)

Install Date:*