Hyundai Reimbursement Mpg – Fill Out and Use This PDF

1)

Website:

www.HyundaiMPGinfo.com

2)

Email:

HyundaiMPGinfo@hmausa.com

3)

Mail to:

Hyundai MPG Call Center

4)

Fax:

(800) 332-2848

P.O. Box 83835

Phoenix, AZ, 85071-3835

City:

State:

Zip:

Telephone:

Email:

(VEHICLE IDENTIFICATION NUMBER)

VIN: __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ Current Mileage:___________________

Date of Purchase:

Date of Sale (if applicable):

Dealership

□ I purchased the vehicle used and currently own it. Enclosed is proof of the mileage at the time I purchased the

vehicle (Please enclose a purchase document, odometer disclosure statement, smog certification, repair order or other document demonstrating

mileage at time of purchase).

ONE

□ I have recently obtained a mileage reading at a Hyundai Dealership, OR

□

I will wait until I accumulate more miles on my vehicle before I obtain a mileage reading at a Hyundai

CHECK

Dealership

Former Owners:

□ I purchased the vehicle new and sold or disposed of it. Enclosed is proof of the mileage I incurred while I owned the

vehicle (Please enclose a sale document, odometer disclosure statement, smog certification, repair order or other document demonstrating

mileage at the time of sale/disposal).

□ I purchased the vehicle used and sold or disposed of it. Enclosed is proof of the mileage I incurred while I owned the

vehicle (Please enclose purchase and sale documents, odometer disclosure statements, smog certifications, repair orders or other documents

demonstrating mileage at both the time of purchase and sale/disposal).

Signature:

Date:

________

MPG (vA 20121109)

Any questions? Visit www.HyundaiMPGinfo.com OR contact the Hyundai MPG Call Center @ (877) 277-0012