Warranty & Non-Warranty Consumer Form Date of Install Date of Product Purchase Name Surname Mobile Number Email ID Number Vehicle Make Vehicle Model Vehicle Year Authroized Dealer Name Some Products Require an Authorized Dealer to complete an Installation to Retain Warranty. Please select an option below. Yes, I will choose a Local Dealer to complete my installation & retain my Warranty. No, I would like to do the Installation myself and forfeit my Warranty & I understand the decision I am making. Please note that if you do not select a dealer & Accept the Terms and conditions that a Dealer will need to complete the install of the product you are purchasing, you will forfeit your warranty. Do you accept the terms & conditions? I Accept I Decline Name This field is for validation purposes and should be left unchanged.