REA-7 AIRBAG MODULE RESET SERVICE

REACTIVATION FORM

RESET YOUR MODULE AIR BAG IN 3 EASY STEP:

1) Complete the following form
2) Once completed, print it.
3) Send your airbag module to us, including your printed form into a secured box

You will receive an email when your order is shipped.

AIRBAG MODULE CAR IDENTIFICATION:
MAKE:
MODEL:	(Ex: Golf GTI 2.8)
YEARS:	(Ex: 2004)
VIN:	(17 char)
VEHICULE OWNER NAME:

BILLING & DELIVERY INFORMATIONS: IMPORTANT : Please give us an address where there’s alway somebody to sign on delivery between 8h and 17h business days only.
BUSINESS NAME:	(Ex: Auto fix inc)
YOUR NAME:	(Ex: John Nash)
EMAIL:
PHONE:	(Ex: 450-123-1234)
FAX	(Ex: 450-123-1234)
DELIVERY ADDRESS IS:	COMMERCIAL OR RESIDENTIAL
STREET:	(Ex: 123 Avenu)
CITY:	(Ex: Montreal)
POSTAL CODE:	(Ex: X0X 0X0 or 654321)
STATES:	(Ex: Quebec)
COUNTRY:	(Ex: Canada)