Kelly-Moore Paints
Acry-Shield 10-Year Warranty

ALL FIELDS MUST BE COMPLETED

I have read and agree with the terms and conditions

Paint applied by:

Painting Contractor
Property Owner
Both

Painting Contractor Information (if applicable)
Name:

Address:

Phone Number:
Property Owner Information
Name:

Address:

Phone Number:

Structure Type:

Kelly-Moore Original Invoice(s) Number(s):

Dates of Coating Application:

New
Previously Painted

Total Square Feet of Surfaces Painted:

Substrate(s):

Total Gallons of Acry-Shield Primer Applied:

Total Gallons of 1240/1245 Acry-Shield Finish Applied:

Methods of Application:

Your Email Address:

Acry-Shield Warranty Applications Must be Received by Kelly-Moore within 60 Days of Coating Application. Effective Date of "Acry-Shield Warranty Program" August 1, 2009

For additional information,
please call 1.888.MR.PAINT (677.2468)

 

BEFORE YOU SUBMIT THIS FORM:
You must enter the numbers you see:
captcha image