Required registration information, Vehicle & component information, Remittance instructions – Spicer Purchased Warranty Registration Form – Vocation Mining User Manual
Page 2

Purchased Warranty Registration Form – Vocation Mining
This form should be used to register eligible vehicles. Completion of this form is only required for a purchased extended warranty.
Important: To ensure this Extended Warranty registration can be processed, please provide complete and accurate answers to the
information requested below. Failure to do so could cause delays in registering the vehicle.
Required Registration Information
Owner: ____________________________________
Dealer__________________________________
Address____________________________________
Address:________________________________
City__________________________ State_________
City:______________________ State_________
Postal Code_________________________________
Postal Code: _____________________________
Email:_____________________________________
Email:__________________________________
Vehicle & Component Information
Chassis Vin (17 Characters): __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
OEM:____________
Current Mileage:________________
Vehicle In-Service Date_____________
License Plate #: ________________ State: ______________
Drive Axle: Model______________
Drive
Axle Serial No.______________
Steer Axle: Model______________
Transmission: Model______________ Trans Serial No.___________________
Clutch:
Model______________
Suspension:
Mfg _________ Model ______________
Drive Shaft Series: Main _______________ Interaxle ______________
Engine: Make________________ Model _____________
Peak Torque ___________Lb.Ft.
________________________________________________________________________________________________
Remittance Instructions
Checks should be made Payable to Dana - CVSD. Checks may be written by the dealer or the owner. Check and registration forms
should be mailed to the following address:
Dana- CVSD
Attn: Warranty Registration
Check
#_______________
P.O.
Box
4097
Check Date: ____________
Kalamazoo, MI 49003-4097
Check
Amt:
___________
_______________________________________________________________________________________________
Before signing below, please read this section carefully!
I/we have read, understand and accept the terms of the Extended Warranty as set forth in bulletin abib-0501.
I/we do not wish to purchase extended warranty at this time and acknowledge that this warranty must be purchased
within 12 of the date the vehicle is placed in service.
I/we understand, if this extended coverage is not purchased, Dana’s warranty obligation will end at the expiration of the
base/standard warranty coverage period.
OWNER Signature:_____________________________________ Dealer Signature: ____________________________
Date: ____/____/____
Dealer (Printed): ____________________________
For spec’ing or service assistance, call 1-800-24 hours a day, 7 days a week
Or visit our web site at:
http://www.VSLFHUSDUWV.com
Dana
Corporation
ABIB-0501
Copyright Dana Corporation, 2005
Heavy Vehicle Technologies and Systems Service
January
2005
All
Rights
Reserved. P.O.
Box
Printed in U.S.A.
www.dana.com
7ROHGR2KLR