Private Party Warranty Registration

Private Party Warranty Registration


 

Thank you for your business. By filling in the form below, you will activate the warranty for your customer’s purchased product. Confirm with your customer that s/he has registered the product for warranty. Please fill in all the compulsory fields in the form completely. Compulsory fields are marked with a red asterisk

General Information

Date:

Product Model:

Kit Front VIN #:

Purchased Date:

Kit Rear VIN #:

Purchased Store Address:

Installer Name:

Purchased Store Name:

Installer Phone #:

Purchased Store Phone #:

Installer Address:

Description of problem and condition:

Car Information

Manufacturer:

Model:

Year:

Type:

Weight:

Engine Poer:

Weight Balance:

Tire Name:

Front Tire Size:

Rear Tire Size:

If car is not stock, please give us detail information:

Customer Information

First Name:

Last Name:

Address:

Phone:

Cell Phone:

Email Address:

Work Phone #:

Credit Card Information

First Name:

Last Name:

Shipping Address:

Billing Address:

Card Type:

Card Number:

Expiry Date:

Security #:

Verification Code:
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Read the agreement Here  I have read and agree the agreement