Lowrance, Simrad and B&G Installation Rebate Claim Form

This form allows you to enter installation rebate claim for Lowrance, B&G and Simrad products.

Claim forms must be submitted within 60 days of installation.

For any questions regarding this program, outstanding claims, or for feedback regarding this form, please email sis@navico.com.

DEALER INFORMATION

Dealer Number * 🛈

Dealer Name *

Email Address *

Street Address *

City *

State/Prov/Territory *

Zip/Postal Code *

VESSEL OWNER INFORMATION

Owner Name *

Phone Number *

Email Address *

Street Address *

City *

State/Prov/Territory *

Zip/Postal Code *

VESSEL INFORMATION

Install Date * 🛈 +

Year *

Make *

Model *

Hull Identification No (HIN) * 🛈

Length *

PRODUCT INFORMATION

Select the installed product from the drop down list and then enter the quantity. Once you make your selection the serial number field will appear. You must enter a serial number for each product installed - entering "SEE NIF FILE" in this field will result in a denied claim.

If you need to remove a line, click the drop down and go to the very top where there is a blank selection and then remove the quantity.

Lowrance (No maximum per boat)

Qty

Product

Serial Number * 🛈

+-

Qty

Product

Serial Number *

+-

Qty

Product

Serial Number *

+-

Qty

Product

Serial Number *

+-

Qty

Product

Serial Number *

+-

Current Lowrance Total: (click Calculate after entering all Lowrance products installed.)

$0.00

B&G and Simrad (No maximum per boat)

Qty

Product

Serial Number *

+-

Qty

Product

Serial Number *

+-

Qty

Product

Serial Number *

+-

Qty

Product

Serial Number *

+-

Qty

Product

Serial Number *

+-

Qty

Product

Serial Number *

+-

Qty

Product

Serial Number *

+-

Qty

Product

Serial Number *

+-

Qty

Product

Serial Number *

+-

Qty

Product

Serial Number *

+-

Qty

Product

Serial Number *

+-

Qty

Product

Serial Number *

+-

Qty

Product

Serial Number *

+-

Qty

Product

Serial Number *

+-

Dealer/Technician Certification Number (If you know your certification #, enter it here.)

Attach the NIF File/Link Pro (if available) 🛈

This field is being provided in the event you need to attach more than one NIF/LinkPro file. 🛈

CLAIM FORM TOTALS

$0.00

Current Claim Total (click Calculate to view the total amount claimed): 🛈

NOTE: Once you hit "Continue", the total on the following page is the amount that will be submitted to Navico for review/approval/payment. Please ensure the form is accurate before hitting the "Confirm Claim/Rebate" button. If changes are needed, click the "Back" button. Once you hit "Confirm Claim/Rebate", you will receive a Confirmation message with your reference number. Please be sure to keep track of this number as this will appear on your check when claims are paid. You also have the option to print the claim information for your records. You should expect to receive payment for valid claims within one week of submission.