CUSTOMER MPG CLAIM FORM
Please register by one of the following methods:
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Website: |
www.HyundaiMPGinfo.com |
2) |
Email: |
HyundaiMPGinfo@hmausa.com |
3) |
Mail to: |
Hyundai MPG Call Center |
4) |
Fax: |
(800) 332-2848 |
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P.O. Box 83835 |
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Phoenix, AZ, 85071-3835 |
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Contact and Vehicle Information
To receive a reimbursement1, provide your current contact information and your vehicle information below:
Name:
Address:
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(VEHICLE IDENTIFICATION NUMBER) |
VIN: __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ Current Mileage:___________________ |
Date of Purchase: |
Date of Sale (if applicable): |
Mileage at Purchase: ____________________ Mileage at Sale (if applicable): ________________
Mileage Verification (Check ONLY ONE of the following boxes.)
Current Owners:
□ I purchased the vehicle new and currently own it.
□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
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Dealership |
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□ I purchased the vehicle used and currently own it. Enclosed is proof of the mileage at the time I purchased the |
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vehicle (Please enclose a purchase document, odometer disclosure statement, smog certification, repair order or other document demonstrating |
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mileage at time of purchase). |
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ONE |
□ I have recently obtained a mileage reading at a Hyundai Dealership, OR |
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I will wait until I accumulate more miles on my vehicle before I obtain a mileage reading at a Hyundai |
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CHECK |
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Dealership |
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Former Owners: |
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□ I purchased the vehicle new and sold or disposed of it. Enclosed is proof of the mileage I incurred while I owned the |
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vehicle (Please enclose a sale document, odometer disclosure statement, smog certification, repair order or other document demonstrating |
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mileage at the time of sale/disposal). |
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□ I purchased the vehicle used and sold or disposed of it. Enclosed is proof of the mileage I incurred while I owned the |
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vehicle (Please enclose purchase and sale documents, odometer disclosure statements, smog certifications, repair orders or other documents |
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demonstrating mileage at both the time of purchase and sale/disposal). |
Certification
The information on this form is true and correct to the best of my knowledge and belief. I consent to Hyundai’s method of calculating my reimbursement as set forth at www.HyundaiMPGinfo.com. I also hereby authorize Hyundai Motor America to contact me in writing, by phone or by email with any questions about my claim submission or regarding the status of my claim submission.
Signature: |
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Date: |
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1Mileage will not be reimbursed for owners taking ownership of any of the affected vehicles after November 2, 2012. In order to be eligible for reimbursement, a customer must register and complete all required claim steps prior to November 3, 2013.
MPG (vA 20121109) |
Any questions? Visit www.HyundaiMPGinfo.com OR contact the Hyundai MPG Call Center @ (877) 277-0012 |
