Request an Equipment Change

(changes will be effective upon confirmation by a King & Neel representative)


Please use your TAB key to move through the form...

(* means required)

 

  * Your Business Name  
* Your Name 
      * Phone 
 * Email Address 
  Fax Number

 * Effective Date of the Change

 

 

Bought a piece of equipment
Got rid of a piece of equipment vehicle
Change to existing equipment
Other (specify below) 

 

 

Description of the equipment to change:

* Model Year 

   * Make/Model 
Type 

 * Serial Number 
Insure for $ 

  Replacement Cost   Actual Cash Value

 

Description of any parties with Additional Interests:

Is the equipment financed?  YES  NO

 Is the equipment leased?  YES  NO


If yes, full name and address of the Loss Payee:
(a certificate of insurance will be issued)


If yes, full name and address of the Lessor
(a certificate of insurance will be issued):

OTHER COMMENTS OR REMARKS?

If you would like a copy, please PRINT before hitting "submit".  Thank you!