WARRANTY REGISTRATION

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Please completely fill out the form provided below to register your air or water filter. Please e-mail or print and fax/mail this form within 30 days from the date of purchase.

First Name*

Last Name*

Company

Address*

City*

State*

Postal Code*

Country*

Email*

Home Phone*

Fax #

Purchased From*

Please provide the type of filter purchased: You MUST choose product from the drop down list to validate warranty.

Enter the date of Purchase
Date

Enter the date of installation
Date

We value our customers opinion and we would like to hear from you. On occasion, we like to quote comments in our literature.
If we choose your quote, we'll send you a $10.00 Gift Certificate towards your next purchase.

Please check the appropriate box :

Yes, you may use my comments.

No, you may not use my comments.

Please click the "Submit Button" or Print and Fax to: 1866-479-7001

Bethel Refuge Enterprises, Inc.
7185 Eagle's Mount Lane, Edwardsville IL. 62025
Fax: 1-866-479-7001, Sales: 1-866-478-1092 U.S. Only
E-mail: sales@bre.com

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