Yugo L4-1300cc 1.3L (1991)
Administrator National Highway Traffic Safety Administration Washington, DC 20590
Auto Safety Hotline:
1-800-424-9393 (Washington area residents: (202)366-0123).
We sincerely apologize for any inconvenience that you experience as a result of this recall. Thank you very much for your cooperation in this matter.
We hope that your Yugo ownership experience will be otherwise long and satisfying.
Claim Form
CAMPAIGN NO.: 91V130
R/O CTL NO.:
DATE:
OWNER'S NAME: __________________________
ADDRESS:
________________________
CITY:
______________________________ STATE: __ ZIP:______-____
TELEPHONE:
(___) ___-____
DEALER TEL. NO.: (___) ___-____
DEALER NAME: _____________________________
YEAR:
__ MODEL: ___ VIN:_____________________ MILEAGE: __________
***** DO NOT SUBMIT THROUGH T.E.C. - MUST MAIL TO YUGO AMERICA, INC *****
ALL INFORMATION MUST BE FILLED IN TO RECEIVE WARRANTY REIMBURSEMENT
REPAIR COMPLETED:
__/__/__ REPLACED ___ GROMETS PART NO. 2923
BY DEALER (CODE): __-____
OWNER'S SIGNATURE: ________________________________________________ DATE: __/__/__
DEALERSHIP'S SIGNATURE: ___________________________________________ DATE: __/__/__
NOTE
IF YOU ARE NOT THE PRESENT OWNER, PLEASE INDICATE VEHICLE STATUS:
__ TOTALED
__STOLEN
__ OTHER : _____________________________________
SOLD TO
NAME: __________________________________________
ADDRESS:^?12G______________________________________________
CITY:
_________________________________ STATE: __ ZIP: _____-____