Dealer Name *

Dealer Email *

City *

Postal/ Zip Code *

Salesperson First Name

Salesperson Last Name

Salesperson Email Address

Phone number (123-456-7890)

Upload copy of sales contract (Retail Rebate) Please ensure your file name does not include any special characters (#, &, @, etc.) *

Upload copy of W9 Tax Form (USA Only)

Need to download a W9 form?(USA Only)

You can do that here: https://www.irs.gov/pub/irs-pdf/fw9.pdf

Company/ Farm Name

Customer Last Name *

Customer First Name *

Customer Phone (123-456-7890) *

Address 1 *

Address 2

City *

Postal/ Zip Code *

Date of sale from contract *

Product Model * PRO-TILL - 10FT PRO-TILL - 13FT PRO-TILL - 20FT PRO-TILL - 26FT PRO-TILL - 28FT PRO-TILL - 30FT PRO-TILL - 33FT PRO-TILL - 36FT PRO-TILL - 40FT PRO-TILL - 41FT PRO-TILL - 45FT PRO-TILL - 20FT HD PRO-TILL - 26FT HD PRO-TILL - 14FT NT PRO-TILL - 17FT NT PRO-TILL - 20FT NT SCORPION HITCH - BIFOLD SCORPION HITCH - 3PLEX STRAWMASTER 5 ROW - 30FT STRAWMASTER 5 ROW - 50FT STRAWMASTER 5 ROW - 70FT STRAWMASTER 5 ROW - 82FT STRAWMASTER 7 ROW - 50FT STRAWMASTER 7 ROW - 70FT STRAWMASTER 7 ROW - 82FT STRAWMASTER 5 ROW - 38FT NT STRAWMASTER 5 ROW - 54FT NT STRAWMASTER - EURO - 22FT STRAWMASTER - EURO - 30FT STRAWMASTER PRO 80FT STRAWMASTER PRO 100FT STRAWMASTER PRO 120FT STRAWMASTER+ 4 ROW - 70FT STRAWMASTER+ 4 ROW - 90FT STRAWMASTER+ 5 ROW - 70FT STRAWMASTER+ 5 ROW - 90FT STRAWMASTER+ 7 ROW - 70FT STRAWMASTER+ 7 ROW - 90FT STRAWMASTER X 50FT STRAWMASTER X 70FT LANDROLLER 20FT LANDROLLER 34FT LANDROLLER 45FT LANDROLLER 51FT LANDROLLER 64FT LANDROLLER 80FT LANDROLLER - HY-ROLLER 41FT LANDROLLER - HY-ROLLER 46FT LANDROLLER - HY-ROLLER 51FT LANDROLLER - HY-ROLLER XL 41FT LANDROLLER - HY-ROLLER XL 46FT LANDROLLER - HY-ROLLER XL 51FT ROCK PICKER - 6000 ROCK PICKER - 7200 ROCK KING 9600 R570P - PRONG TYPE RR1500 ROCK RAKE RD320 ROCK DIGGER SUPER PICKER III 7800 MANURE SPREADER - M28 MANURE SPREADER - M34 ROTARY CUTTER - 10FT ROTARY CUTTER - 15FT SIDEARM 1220 SIDEARM 1800 SIDEARM 1820 LIQUIFIRE 7900 SERIES 7200 SERIES 6900 SERIES 6600 SERIES 5900 SERIES 46/5700 SERIES 3500 SERIES 34/44 SERIES SPEED BLADE SILAGE KING STRONGBOX TRUGRADE 16 PRO-CAST 28 PRO-CAST 80 PRO-CAST 120 HDSR 930 HDSR 1320 HDSR 1130 HDSR 1520

Tractor (if applicable)

Hours

Drive Type

Serial # *

DOUBLE CHECK YOUR INFORMATION

Please ensure that information is accurate before submitting. Inaccurate information could delay warranty claims in the future.

Intended First Day of Use *