APPLICATION FOR A CERTIFICATE OF CONFORMITY/ DATING
Transcription
APPLICATION FOR A CERTIFICATE OF CONFORMITY/ DATING
APPLICATION FOR A CERTIFICATE OF CONFORMITY/ DATING LETTER Please fully complete the details below: PART ‘A’ Which certificate do you require: (Please tick appropriate box) Certificate of Conformity Dating Certificate Both PART ‘B’ (Application Details) *delete as appropriate NAME: Mr / Mrs / Miss* ADDRESS: ARE YOU THE ORIGINAL OWNER? TELEPHONE NUMBER EMAIL ADDRESS YES NO Please appropriate box PART ‘C’ (Vehicle Details) MODEL: VEHICLE IDENTIFICATION (CHASSIS) NO: PLACE OF FIRST REGISTRATION: DATE OF FIRST REGISTRATION: Has the vehicle been altered, modified, written off or rebuilt since leaving the original production factory: If YES, please give details: WORK CARRIED OUT YES NO Please appropriate box CARRIED OUT BY Continued over page -2- DECLARATION I understand that: 1) The duplicate Certificate of Conformity does not imply approval by MG Rover Group in Liquidation of the standard of workmanship of any alteration to the vehicle’s original specification (including conversion of steering hand). 2) MG Rover Group in Liquidation accepts no liability however arising in respect of the issue of the duplicate Certificate of Conformity and/or Dating Certificate and therefore are unable to refund any monies paid. 3) MGR C&C Services accepts no liability however arising in respect of the issue of the duplicate Certificate of Conformity and/or Dating Certificate and therefore are unable to refund any monies paid. * Please tick one Service Level and one Method of Payment (Note V.A.T. is not payable): Chosen Delivery Service Dating Certificate Cert of Conformity Dating Certificate Cert of Conformity UK Standard Service UK Special Service £100.00 £150.00 £100.00 + £7.50 (£107.50) £150.00 + £7.50 (£157.50) Internat’l Std Service Internat’l “Sign For” Service €127.00 €190.00 €127.00 + €13.00. (€140.00) €190.00 + €13.00 (€203.00) Note: No V.A.T. is payable Method of Payment: Bank Card Postal Order Pay Pal Bankers Draft Bank transfer Cheque Please send your payment, together with this application, as full and final payment for a delivered Dating Certificate / Certificate of Conformity. To: MGR C & C Services Ltd PO Box 13279 Stoke Heath Bromsgrove B60 9BS Signature: Date: Name: (BLOCK CAPITALS)