EVSE Warranty Registration Form
Style (12 Digits)
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Serial # (11 Digits)
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Customer Information

Customer name
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Customer address
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Zip code
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Installer Information

Installer name
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Integrator / Installer address
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Zip code
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Installer phone number
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Integrator / Installer email address
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System Information

Installation date
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Indoor or Outdoor location?
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Dedicated Breaker Size
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Other Breaker Size
 
Wire Gauge
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Vehicle Mfg / Model / Year
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