D-Celerator Diesel Exhaust Brake Product Registration

After you submit this form, we will add your information to our product registration database.  Remember that warranty claims must be pre-approved, and must be accompanied by your proof-of-purchase (work order, bill of sale, credit card receipt, cancelled check, etc.).

Please provide the following product information:

Electronics Serial Number:
Model Number
Serial Number
Build Date:

Please provide the following contact information:

First Name
Last Name
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Phone
E-mail
Please provide the following purchase information:
Date of Purchase
Dealer Name
City
State/Province
Phone

Please provide the following vehicle information:

Make, Model, and Year:
Miles on vehicle:
How used:
Total GVW:
Comment:

Validate (required): Type the following word into the box: