WARRANTY

Name of Previous Owner

Name of Previous Dealer

Customer First Name*

Customer Last Name*

City

State/Region*
—Please choose an option—AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

Customer ZIP Code*

Customer Country*

Cart Model*
—Please choose an option—Please SelectC20AMBC20SC20UC20ULC20VC20VLC30AMBC30AMBLC40C40FLSC40FSC40FS-LC40LC60C60FSC60LC60SC70WC80E20E40E40FE40FLE40FXE40LE60E60LEB01 E-BikeEB02 E-BikeG40G40LG60G60Li20i20Li20S-HDi20Ui20U-HDi20ULi20UL-HDi40i40-ECOi40Fi40FLi40FS-HDi40Li40L-ECOi60i60-HDi60Fi60FS-HDi60Li80P20P40P40LP60P60LFX20FX40FX60

Cart Color*
—Please choose an option—Please SelectAlpine WhiteAlpine White MetallicBlackBlack DiamondCaribbean BlueCashmereChampagneChampagne MetallicCharcoalCherryForest GreenForest Green MetallicIndigo BlueIndigo Blue MetallicLime GreenMatte BlackMetallic BlackMetallic CashmereMetallic CharcoalMetallic CherryMetallic MidnightMetallic Pearl WhiteMetallic Royal BlueMetallic SilverMetallic Sky BlueMidnightOpalOrangePearl WhitePurplePurple MetallicRaven BlackRaven Black MetallicRedRoyal BlueSangriaSangria Red MetallicScarletSeaglassSilverSilver MetallicSky BlueSlateTangerine OrangeTorch RedTuscan YellowWhiteYellow

Dealership Name*

Date of Purchase*