Dell Warranty - Kustom Signals Inc

Dell Ownership Transfer Information

Form to be completed by SALES for transfer of warranty to customer.

"*" indicates required fields

REF Number

Agency Name*

Order Number*

Where will the computers be located? If more than one location, include all locations.

More than one location?

Yes

No

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Address #2

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Agency Contact for Dell's Record*

First Last

Agency Contact's Email Address*

Agency Contact's Phone Number*

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