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CUSTOMER INFORMATION (Where system(s) are installed)

Make sure that this is the email address of the customer that has purchased the system(s)


Leave blank if not known.

Please provide the main number for the Dealer installing the HALO systems.

Please include primary dealer EMAIL ADDRESS if installer email not available.
System(s) Installed

Enter the date that the system was installed.

Include at least one image of each system installed.Show complete system. Use more than one image if necessary.

Image 1

The System Serial Number is on back of system as shown in image above.