REACTIVATION_2_fr

Airbag reset reactivation order form

$0,00

Module airbag reset price 250$ to 300$ CDN+taxes

MAKE SURE THE PDF FORM IS COMPLETE AND SIGNED

*** Any incomplete, illegible, unsigned form or wrong information on the form will result in an additional charge of $25 + tx on your invoice.

RESET YOUR AIRBAG MODULE IN 3 EASY STEP:
1) Complete the following form
2) Once completed you will receveice a confirmation email (check your spam folder) print it and sign it.
3) Send your airbag module to us, including your printed and singed confirmation email into a secured box.
PLEASE FILL CAR INFO

AIRBAG MODULE CAR INDENTIFICATION:

*MAKE

$

*IF OTHER

$

*MODEL

$

(Ex: Golf GTI 2.8)

*YEAR

$

*VIN
IN CAPITALS PLEASE

$

VEHICLE OWNER NAME

$
PLEASE FILL CONTACT INFO

BILLING & DELIVERY INFORMATIONS:
IMPORTANT :
Please give us an address where there’s always somebody to sign on delivery between 8h and 17h business days only.

BUSINESS NAME

$

*YOUR NAME:

$

*EMAIL

$

*PHONE

$

*DELIVERY ADDRESS IS

COMMERCIAL $
RESIDENTIAL $

*STREET

$

*CITY

$

*POSTAL CODE

$

*STATE

$

*CONSENTEMENT

I declare to have read, understood and accepted these conditions $

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