Warranty Registration

Enroll your customer in our warranty program.

    Dealership Information:

    Your Name (required)

    Your Email (required)

    Dealership Name:

    Dealership Phone:

    Customer (Owner) Information:

    Customer Name:

    Customer Phone:

    Customer Email:

    Customer Mailing Address:

    Address Line 2: (optional)

    City:

    State:

    Zip:

    Automobile Information

    Make:

    Model:

    Year:

    Color:

    VIN:

    captcha

    To submit your Certified 30-Day Cosmetic Warranty registration, enter the letter and/or number combination you see above in to the text box below and hit Submit.

    Contact Information

    Estimates: (559) 555-5555

    Accounting: (559) 555-5555

    Email Us

    Phone: (559) 555-5555
    Toll-Free: (800) 555-5555
    Fax: (559) 555-5555
    eMail: contact@secureitnew.com

    Location & Hours

    Do you want this information here?
    We can include a map if you do.

    Address: 5555 Main Street
    City, California, 99999
    Hours: Mon-Fri, 9:00AM-6:00PM