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Warranty Registration for All Headend Electronics

Please register to qualify for the 5-year warranty, and to receive free product updates.

• The Model number can be found on the front face plate.
• The Manufacture Code can be found on the bottom of the unit. It is a 2 or 3 digit Alpha Code, for example: OL
• Serial number can also be found on the bottom of the unit. It is a 7 digit number, for example: No Y009477.

* Please provide the required information

Model Number *
Serial Number *
Manufacture Code *
Purchase Date	Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007
First Name *
Last Name *
Title
Company Name *
Address 1
Address 2
City
State
Zip
Country
Phone Number *
Fax Number
E-Mail Address *
Type of Business	Please select one Broadcaster CATV Consultant Contractor Dealer/ Reseller Distributor End User Government Hospitals Hotel/Motel Installer Integrator Multiple System Operator (MSO) OEM Prisons Schools Telecom Not listed (enter in Other)

Optional Questions

How did you hear about Pico Macom?

How long have you been using Pico Macom's products? Please select one Less than a year One to two years Two to three years Three to five years Five years or more

What type of equipment do you primarily use? Please select one Headend Distribution Amplifiers Installation Accessories- (clamps, tap brackets, straps, ground blocks) Splitters, Taps, Connectors Not listed(enter in comments)

How many people are in your company? Please select one Less than 10 11 to 25 26 to 50 51 to 99 One hundred or more

From whom do you purchase your cable system equipment?

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Pico Macom, Inc.,
6260 Sequence Drive,
San Diego, California 92121
• 800-421-6511 • 858-546-5050 • FAX 858-546-5051
www.picomacom.com © Copyright 2007, Pico Macom, Inc., All Rights Reserved