1. Name & Address:
2. Date of purchase:
3. SeaLife product purchased: (Please fill in this information, since it is essential for our service.)
Other: (enter item #)
SL
4. Serial Number (Cameras and Flashes Only): (Please fill in this information, since it is essential for our service.)
(Serial number is on outside of camera/housing.)
5. What type of store was this product purchased in?
6. Name of store where purchased:
Country:
State:
City: