Polini THOR 80 Instructions Pour L'utilisation Et L'entretien page 20

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PART NUMBER:
ENGINE SERIES NUMBER:
Company name:
Address:
City:
Country:
Phone number:
E-Mail Address:
Dealer's stamp
and Signature
Name and Surname:
Address:
City:
Country:
Phone number :
E-Mail Address:
Product purchased on:
Purchaser's signature:
- Pursuant to Art. 13 of Legislative Decree No. 196/2003 concerning the treatment of the personal data, the undersigned authorize the
treatment of the transmitted personal data.
Kindly send this certificate by fax to the following number 0039 035 2275281 or by mail to news@polini.com (at
the moment of your purchase) in order to activate the warranty and be always informed about news, recalls or
innovations.
ENGLISH
THOR ENGINES' WARRANTY ACTIVATION
DEALER'S DATA:
PURCHASER'S DATA
ZIP Code:
Fax number:
ZIP Code:
Fax number :
I enclose a copy of receipt/invoice