Installation record

Warranty registration and customer details.

Complete this short form after installation so River City Water Filters can keep the customer's essential warranty record and invoice together.

Customer details Installation date Signed consent Stored submission

Do not fill this out:

Customer

Customer details

Customer full name

Phone

Installation address

Installation

Installation record

Installation date

Click the field to choose a date from the calendar.

Attach invoice

Attach one clear photo or PDF of the invoice.

Consent

Privacy and signature

I confirm these details and the attached invoice are accurate. I have read the Privacy Policy and Warranty Terms. I agree that River City Water Filters may store this record and share relevant details with its supplier or qualified plumber when reasonably required for installation, service or warranty support.

Customer signature (type full name)

Signed date

This submission and invoice will be stored securely in Netlify Forms. Email notifications must be enabled in Netlify for delivery to rivercitywaterfilters@gmail.com.