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mom Horton <br />= EMERGENCY VEHICLES <br />p 614 539.8181 <br />0: 8K282,5113 <br />1' 1311.539.8165 <br />twr tot laniNfle w'oxom <br />V17-MATIMM-4talm, 04RI <br />This form must be completed and submitted to Horton when the vehicle is put into service by the <br />purchaser user (owner). The form must be completed in its entirety with all the requested <br />information provided. * <br />Horton Prod. Number <br />I., <br />in -Service Date <br />Owner <br />Address <br />city State ZiP <br />Phone Email <br />Dealer Authorized Signature <br />Print <br />Owner Authorized Signature <br />Print <br />Date <br />Date <br />Title <br />Submitting this form indicates that the Dealer and Owner have read, understand, and accept the terms of <br />the Horton warranty as detailed on the warranty certificates. If this form is not submitted, the warranty start <br />date will be considered to be the date encoded in the Horton VIN as listed on the yellow complete vehicle <br />sticker located on the driver's side chassis door. <br />* This form is not for use with former demonstrator units. Use the "Demonstrator Warranty Transfer" form. <br />Mail, Email, or Fax to: <br />Warranty Administrator <br />Horton Emergency Vehicles <br />3800 McDowell Road <br />Grove City, Ohio 43123 <br />warranty@hortonambulance.com <br />fax (614) 539-8165 <br />3800 McDowell Road <br />Grove Qy, 01-143123 Rev 102014 <br />