Icynene Warranty and Energy Tax Manufacturer's Certificate

Icynene Lifetime Limited Warranty Registration Form

Thank you for purchasing The Icynene Insulation System^®. Your completed registration form must be sent to and received by Icynene for the warranty to be registered. Valid batch numbers are required to activate your warranty coverage. You can obtain these from your Icynene Licensed Dealer. View Warranty Certificate

Required applicant information:
Name: Street Address:
City: State/Province: Zip/Postal Code:
Phone Number: Email:

Required information - to be completed by the Icynene Licensed Dealer:
Licensed Dealer Company Name: Install Date:

Batch Number(s):
Cost of Icynene^® Installation (product & labor):

Optional information: The questions below are designed to assist Icynene in understanding which benefits are of greatest importance. Your information will remain confidential and will not be shared with any outside organization.

Why did you select The Icynene Insulation System^®?
a) Energy Efficiency
b) Health/Indoor Air Quality Considerations
c) Sound Reduction
d) Environmentally Friendly
e) Concern with Mold
f) For Use in Home Theater
g) Other
Who is the primary decision maker in selecting The Icynene Insulation System^®?
a) Builder/Remodeling Contractor
b) Architect
c) Designer
d) Husband
e) Wife
f) Husband & Wife
g) Insulation Contractor
h) Indoor Air Quality Professional
i) Energy Professional
j) Engineer
Your project was:
a) New Subdivision Home
b) New Custom Home
c) Remodel of an Existing Home
d) Factory Built Home
e) Commercial Building
f) Agricultural Building
g) Other
How did you initially learn about The Icynene Insulation System^®?
a) TV Program
b) TV Commercial
c) Billboard
d) Radio Show
e) Radio Commercial
f) Magazine Ad
g) Newspaper Ad
h) Article/Editorial
i) Brochure
j) Direct Mail
k) Home/Trade Show
l) Internet
m) Friend/Family Member
n) Builder/Contractor
o) Other
If The Icynene Insulation System^® was used in a new home or for a remodeling project, what is the approximate value of your home?
a) Under $100,000
b) $100,000-$200,000
c) $200,000-$300,000
d) $300,000-$400,000
e) $400,000-$1,000,000
f) $1,000,000-$1,500,000
g) Over $1,500,000
If The Icynene Insulation System^® was used in a new home or for a remodeling project, what is your approximate total household income range?
a) Under $50,000
b) $50,000-$100,000
c) $100,000-$150,000
d) $150,000-$200,000
e) More than $200,000
Overall, how satisfied are you with The Icynene Insulation System^®?
a) Very Satisfied
b) Somewhat Satisfied
c) Somewhat Dissatisfied
d) Very Dissatisfied

I have read/agree with the Warranty Certificate

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Print this pageThursday, August 21, 2008