New Dealership Warranty

Personal Details

Title:

First Name:

Surname:

Phone (daytime):

Phone (home):

Email:

Fax:

Address:

Postcode:

Dealership Details

Branch/Dealership:

Customer Advisor:

Vehicle Details

Reg No.

Fuel Type:

Purchase Date:

VIN:

Transmission:

Invoice Value:

Vehicle Make:

UK Spec:

Current Mileage:

Vehicle Model:

Manufacturer's Expiry Date:

Registration Date:

MOT Due Date:

Warranty Details

Products Applied:

Cover Start Date:

Cost:

Declaration

I/We confirm that the answers to the questions In this Guarantee Schedule are true and to the best of my/our knowledge. I/We have received the Terms and Conditions for the product(s) listed above.

I confirm that I:

wish to take additional cover.

Please confirm:

I agree with the above statement

Input Initials:

Date:

Retailers Declaration

Duty of Disclosure

You must give full and true answers to all questions in this Guarantee Schedule. If you do not do so, your warranty may not protect you in the event of a claim.

Duracare Products Limited – Privacy Notice

Your privacy is important to us and we would like to keep you informed on how we use your personal information to set up the products and services presented to you by Duracare Products Limited or a supplying retailer. We will never share your information with any third parties.

You have provided consent via the retailer for Duracare Products Limited to keep you informed about our products, services and promotions by

Contact:

You can withdraw your consent to receive this information at any time by contacting us at info@dura-care.com

DURACARE VEHICLE PROTECTION PRODUCTS ARE THE ULTIMATE IN VEHICLE PROTECTION

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Duracare Warranty Registration

DURACARE VEHICLE PROTECTION PRODUCTS ARE THE ULTIMATE IN VEHICLE PROTECTION