Vehicle details (3/4)

Name & full address of user (4/4)

(If the applicant is not the User of the product, please enter both the User’s name and the name of the contact person handling this application on their behalf 

USER’ S DECLARATION 

1. I/We certify that the product referred to above is my/our property and was fitted to my/our vehicle of which details are given above.
2. I/We consider the product has not given satisfactory service whilst on my/our vehicle and request you arrange examination by the manufacturer.
3. I/We declare that the above mentioned tyre/tube caused no damage to vehicles, property or injuries to people and hence no consequential claim will be made related to the tyre/tube detailed on this form.
4. I/We declare the details given above are correct to the best of my/our knowledge.
5. I/we agree that my/our personal data set out in this Form may be retained by the Dealer in its records and be passed on to the Manufacturer of the product (and/or its relevant affiliate) which may hold and process my/our information in order to deal with this application on the terms of its privacy made available on the manufacturer's website.