Office: 1505 - 7th Street                    Mailing:  P.O. Box 906           Tel:  +1-309-764-9842        Fax:  +1-309-764-9848          Email:  info@lift-systems.com
East Moline, IL 61244                           Moline, IL 61266
FIRST NAME
LAST NAME
COMPANY NAME
TITLE
ADDRESS 1
ADDRESS 2
CITY
STATE
POSTAL CODE
COUNTRY
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PHONE
PRODUCT PURCHASED
HYDRAULIC GANTRY SYSTEM
 MOBILIFT
TWINLIFT
POWER TOWER
TF45/60
OTHER
CRAWLER MOUNTED TRANSPORTER
CUSTOM BUILT CYLINDERS
INDUSTRIAL TRAILER
MACHINE INFORMATION
MACHINE MODEL NUMBER (CAPACITY IF MODEL UNKNOWN)
SERIAL NUMBER (IF KNOWN)
DATE OF PURCHASE
TYPE OF PURCHASE (AUCTION, PRIVATE PARTY, ETC.)
WHO DID YOU PURCHASE YOUR UNIT FROM?
(THIS WILL ALLOW US TO BETTER DETERMINE WHICH UNIT YOU
PURCHASED)
ACCESSORIES PURCHASED WITH UNIT
REQUEST INFORMATION OR LEARN MORE ABOUT AVAILABLE UPGRADES
AND SERVICES AVAILABLE FOR YOUR LIFT SYSTEMS EQUIPMENT
SEND ME SPECIFICATIONS FOR MY UNIT
SEND ME INFORMATION REGARDING UPGRADES FOR MY UNIT
SEND ME INFORMATION ABOUT RECERTIFICATION FOR MY UNIT
SEND ME INFORMATION ABOUT ACCESSORIES FOR MY UNIT
QUESTIONS OR COMMENTS
PLEASE FILL OUT THE FORM BELOW

When submitted, a person from the  Lift Systems Service Department will update your
machine's file and send you the information you have requested.
ALTERNATIVE LIFTING EQUIPMENT!