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Buyers Registration Form
Top Gun Mobility Scooter
NOTICE: SELLING DEALER SHOULD COMPLETE THIS FORM AT TIME OF
SALE TO REGISTER WARRANTY.
Customer Name:_ _______________________________________________
Address:________________________________________________________
City:_____________________________ State: _______Postcode:__________
Telephone:__________________________Date of Purchase:______________
Email Address: ___________________________________________________
Selling Dealer:
Top Gun Mobility
21 Brisbane Street, Ipswich QLD 4305
Phone :
07 3282 7788
Email :
Model:
_________ TG600RS ______________
Serial Number:
_______________________________________________
Colour:
_______________________________________________
Type of Purchase: Consumer
Rental
Other
Customer Signature
Dealership Representative Signature
