Model Number* (ie. HD30,HDS175,HHD45,etc.) HD 30 HD 45 HD 60 HD 75 HD 100 HD 125 HDS 30 HDS 45 HDS 60 HDS 75 HDS100 HDS125 HHD 30 HHD 45 AMP 57 AMP 90 BDP 150 BDP 175 BDP 200 BDP 250 BDP 300 BDP 350 BDP 400 BTC 215 BTC 260 BTC 310 BTP 150 BTP 175 BTP 200 BTP 250 BTP 300 BTP 350 BTP 400 BTX 150 BTX 175 BTX 200 BTX 250 BTX 300 BTX 350 BTX 400 HDB 100 HDB 125 HDB 60 HDB 75 HDC 100 HDC 125 HDC 60 HDC 75 HER 100 HER 125 HER 150 HER 200 HER 250 HER 30 HER 50 HER 75 HEX 100 HEX 150 HEX 200 HEX 250 HEX 30 HEX 300 HEX 350 HEX 50 HEX 75 MEW 100 MEW 150 MEW 200 MEW 250 MEW 30 MEW 300 MEW 350 MEW 390 MEW 50 MEW 75 PDP 150 PDP 175 PDP 200 PDP 250 PDP 300 PDP 350 PDP 400 PTC 110 PTC 135 PTC 156 PTC 180 PTC 215 PTC 260 PTC 310 PTC 55 PTC 65 PTC 85 PTE 300 PTE 400 PTE 500 PTP 150 PTP 175 PTP 200 PTP 250 PTP 300 PTP 350 PTP 400 PTX 150 PTX 175 PTX 200 PTX 250 PTX 300 PTX 350 PTX 400 VE 100 VE 150 VE 200 VE 250 VE 300 VE 400 VE 50 VE 500 VE 75 Date of Purchase Purchased from Company Name* Purchased from Address:

Select the Installation Location Type* Residential Commercial/Industrial Greenhouse Owner First Name Owner Last Name Owner Address Owner City Owner State/Province AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY AB BC MB NB NL NS NT NU ON PE QC SK YK Owner Zip Owner Phone Number Owner Email Address*

What type of purchase was this? Replacement of an existing unit Add-on (additional equipment added to home) New construction How did you learn about this product? ContractorAdvertisementInternetBuilderFriendHome ShowOther* If other is selected* Why did you buy the Modine HotDawg heater? Select up to two reasons Contractor Recommendation Ease of Installation Price Safer garage-heating Alternative Unit Sizes Offered Convenience

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