Karma KP-80, Owner'S Manual, Page: 58 / 60

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Warranty Form (You may photocopy this from)
Full name:
Gender: □Male □Female
Date of Birth:
MM/ DD/ YYYY
/ /
Address:
Model: KARMA KP-80
Serial Number:
Date of Purchase:
MM/ DD/ YYYY
/ /
Purchaser Signature:
Dealer's Data
Name of store:
Telephone and Address:
If you have any suggestions on how to improve our products, please don't
hesitate contacting your local dealer to let us know what you think of your
wheelchair. Thank you and enjoy.