50
Warranty Form (You may photocopy this from)
Full Name:
Gender:
□
Male
□
Female
Date of Birth:
Year Month Day
Address:
Model:
KARMA Saber Series
Serial Number:
Date of Purchase:
Year Month Day
Purchaser Signature:
Dealer's Data
Name of the Store:
Phone No. 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.
