Customer Machine Delivery Form

"*" indicates required fields

Facebook

This field is for validation purposes and should be left unchanged.

Serial Number*

Name of Dealership*

Front Chain

Rear Chain

Additional Equipment/Chain Supplied

Place of Delivery

Date of Delivery

I acknowledge that:

I have received a Kelly operators manual to suit this machine

I have been shown in the manual where to find safety information, safe operating guidelines, technical specifications and warranty information

I have been shown the recommended maintenance checklist

I have been shown where to find information for this machine on the Kelly website

I have received and completed the warranty registration form

Name*

First Last

Email*

A copy of the completed form will be sent to this email address.

Date*