It is very important for you to provide as much accurate information as possible. Your information will be reviewed and a reply will be sent to the e-mail address that you provide. The fields marked with an asterisk are required.If you experience trouble with this on-line form, please do not hesitate to contact us.

TCI® Automotive Limited Warranty Registration

For original owners only against defect in parts & workmanship.

This form must be filled out within 10 days of purchase to validate warranty. Proof of purchase is required so please retain your sales receipt.

Product*
Part Number*
Serial Number*
Date Purchased*	(MM/DD/YYYY)
Product Purchased From*
Product Purchase Online*	Yes No
First Name*
Last Name*
Address*
City*
State*	SELECT Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Postal/Zip Code*
Phone*
E-mail*
Vehicle Make*
Vehicle Model*
Vehicle Year*
Which Type Of Application Best Describes The Product’s Intended Usage?
	Drag Racing
	Oval Track Racing
	Street Performance
	Show Car
	Street Rod
	RV/Towing
	4x4 Off-road
	Daily Driver/Fuel Economy
	Marine
	Other:
Which Of The Following Would You Consider Your Most Valuable Technical Resource For Your Vehicle?
	Magazines/Publications Manufacturer Websites Online Forums/Message Boards Technical Books Television Other:
Which Factors Most Influenced Your Buying Decision?
	Advertising/Marketing
	Brand Reputation
	Ease Of Installation
	Availability
	Performance
	Price/Value
	Product Selection
	Prior Brand Experience
	Quality/Dependability
	Store Display
	Recommendation/Endorsement
	Related Components
	Shipping Options
	Product Features
	Technical Support
	Warranty
	Other: