Form Mech 116 Cpa PDF Details

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QuestionAnswer
Form NameForm Mech 116 Cpa
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesADMINISTRATORS, Powertrain, CPA, BLVD

Form Preview Example

TRANSFER REQUEST

CONSUMER PROGRAM ADMINISTRATORS, INC. 175 WEST JACKSON BLVD.

CHICAGO, ILLINOIS 60604

Procedures:

We will accept transfer of this Mechanical Repair Service Contract if:

•the Mechanical Repair Service Contract allows for the transfer of coverage.

•the remaining portion of the original manufacturer warranty including Powertrain warranty has not been reduced or voided.

•a transfer fee* is paid to Consumer Program Administrators, Inc. within 30 days of the sale to the subsequent owner.

•the Agreement Holder provides you with all records of required maintenance applicable during the Agreement Period.

*SEE MECHANICAL REPAIR SERVICE CONTRACT FOR APPROPRIATE TRANSFER FEE AMOUNT.

Transferred From:

Name

 

Telephone (Include Area Code)

 

 

 

Street

 

 

 

 

 

City

State

Zip Code

Signature Of Previous Owner:

Transferred To:

Name

 

Telephone (Include Area Code)

 

 

 

Street

 

 

 

 

 

City

State

Zip Code

I have read and understand all of the terms and conditions of the Mechanical Repair Service Contract. I have paid the appropriate transfer fee amount. I also understand the transfer applies only to the remaining months and miles of the original Mechanical Repair Service Contract term. I have received from the Agreement Holder records of all required maintenance applicable during the Agreement Period to date and I understand that I am responsible for all maintenance that the Agreement Holder was required to perform.

Signature Of New Owner:

Vehicle and Dealer Information:

Contract Number

 

 

 

 

 

 

 

 

Company Code (For Internal Use Only)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Vehicle Identification Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Make

 

Model

 

 

 

 

 

 

 

 

Year

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Odometer Reading At Date Of Transfer

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date Of Transfer

Month

 

Day

 

Year

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Issuing Dealer

 

 

 

 

 

 

 

 

Dealer Number (For Internal Use Only)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mail a copy of this Transfer Request form with the appropriate transfer fee to:

CONSUMER PROGRAM ADMINISTRATORS, INC. 175 WEST JACKSON BLVD.

CHICAGO, ILLINOIS 60604

MECH-116 CPA (R 05/07)

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Best ways to prepare Issuing portion 1

2. Soon after filling out the last section, head on to the subsequent part and enter the essential details in all these blank fields - Vehicle Identification Number, Make, Model, Year, Odometer Reading At Date Of, Date Of Transfer, Issuing Dealer, Month, Day, Year, Dealer Number For Internal Use Only, Mail a copy of this Transfer, CONSUMER PROGRAM ADMINISTRATORS, and MECH CPA R.

Issuing writing process clarified (stage 2)

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