PRODUCT REGISTRATION FORMand INSPECTION REPORT 170 Highway 83 North Benito, MB R0L 0C0 T: 1-866-459-0362 P: 866-459-0362 www.agshield.com sales@agshield.comBuyer's Name(Required) Address(Required) Street / Road Address City State Postcode AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe 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FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone(Required) Email(Required) Dealer Company Name(Required) Dealer Email(Required) Salesperson Name(Required) Dealer Township(Required) City Phone(Required) Model Number (eg. 12-46-3, )(Required) Serial Number(Required) Delivery Date(Required) DD slash MM slash YYYY General Purpose(Required) Private Commercial Unit Inspection and Delivery ChecklistGeneral(Required) Inspect paint, decals and general appearance of unit Verify that the owner’s manual is in the manual storage tube Verify “SLOW MOVING VEHICLE” sign (SMV) is on unit Verify that the jack is with the unit and function properly Check wheel bolts for proper torque (135-145 ft-lbs), proper wheel size and all tires are the same make Ensure all axle caps are secure on road wheel hubs Check wheel bearings adjustment on all road wheels Check for proper tire pressure (PSI) Verify that locking pins are in place Lubricate all components as per operator’s manual recommendation Check that all bolts and fasteners are at the proper torque specifications Check locking collars and set screws for proper torque Verify operation of lights Verify the unit moves “IN” and “OUT” of transport without binding Select AllHydraulics(Required) Ensure that all hydraulic hoses and lines are routed properly and secured Verify that all hydraulic fittings / hoses are secure and there are no oil leaks Inspect all cylinders for leakage and the cylinder shaft for rust, pits, or scratches Verify operation of all hydraulic functions – Cycle hydraulic cylinders to remove air from the system Select AllDelivery(Required) Verify that the customer is aware of warning decals and proper jack placement for transport Verify that the customer is aware of proper operation and transportation of the unit Verify that the customer has received an operator’s manual Explain all maintenance and service intervals to the customer (From operations manual) Advise the customer of grease locations and maintenance schedules Level the unit per operator’s manual and instruct the customer on proper procedures Verify that the customer is aware that when towing the Land Roller, they must travel at a safe speed, and not exceed 30 km/hour. Select AllHow did you originally hear about this product?(Required)Search and found on Google for productsAlready aware about products and contacted local DealerWord of mouthFacebook or InstagramTwitterOtherOther (Please tell us where where you heard about this product)(Required) The Salesperson has thoroughly instructed me on the above described equipment. The review included the content of the Operator’s Manual, equipment care, adjustments, safe operation and warranty policy. The above equipment and Operator’s Manual have been received by me.Buyer's Name(Required) Date(Required) DD slash MM slash YYYY Buyer Signature(Required)CAPTCHANameThis field is for validation purposes and should be left unchanged.
