CONSTRUCTION EQUIPMENT AND AGRICULTURAL MACHINERY EXTENDED WARRANTY POLICY

Transcription

1 CONSTRUCTION EQUIPMENT AND AGRICULTURAL MACHINERY EXTENDED WARRANTY POLICY Product Disclosure Statement and Policy Document This product disclosure statement [PDS] contains important information about the Secure Machinery Breakdown Insurance. Please read this PDS carefully as it sets out the benefits of these insurance products [including limits, exceptions, conditions and other terms] and information about your rights. The PDS also contains the terms and conditions of the policy and these terms along with your Policy schedule constitute your Contract of insurance. Underwriter Certain underwriters at Lloyds effected through Horsell international Pty Ltd (ASFL No ) as their agent Definitions 1. Administrator/Us Means Secure Warranty 2. Assured i. shall mean the name specified in the schedule attached hereto, whom shall be domiciled in The Commonwealth of Australia. ii. For the purpose of the attached Schedule the Assured shall also be deemed to mean Owner (or Lessee for the leased products) and therefore Owners of the insured machine. 3. Insured Machines Shall mean the machine described in the schedule attached 4. Underwriters Shall mean the Underwriters as defined in the schedule 5. Repairer Shall mean the Authorised Dealer 6. Components Shall mean those parts installed in the factory or genuine manufacturer parts installed by an authorised dealer. 7. Warrantable Defect Shall mean any Electrical, Hydraulic or Mechanical Breakdown shown to be due solely to defective materials or factory workmanship necessitating repair or replacement in accordance with conditions of the certificate. 8. Repair/Replacement Shall mean the usual and reasonable charges for components and/or labour to repair or replace the Insured machine exclusive of any part of such charges as represents local taxes recoverable by the Assured and any part of such charges that may exceed the Limit of Indemnity for any one claim and for the aggregate of all claims that applies to this policy. 9. Territorial Limits Shall mean the states and territories of The Commonwealth of Australia. 10. Limit of Indemnity The Underwriters liability shall not exceed $50, for any one claim and the aggregate limit is 100% of the equipment s actual cash value during the Period of this policy and as shown on the attached schedule. EXTENDED WARRANTY POLICY 1

2 Warranty No: PLEASE USE BLOCK LETTERS SURNAME (MR/MRS/MS/COMPANY): EXTENDED WARRANTY Administered by Secure Warranty CUSTOMER APPLICATION GIVEN NAME: ADDRESS: SUBURB/TOWN: STATE: POSTCODE: PRIVATE PHONE NUMBER: BUSINESS PHONE NUMBER: FINANCIER (If premium financed)... MACHINE INFORMATION MAKE:...MODEL:. 2WD 4WD SERIAL NO:..HOUR METER READING... PURCHASE DATE.....PURCHASE PRICE: $ APPLICATION (USAGE) PERIOD OF COVER* *1: This includes the manufacturer s warranty period *2: The Warranty expires when the end of the Period of Cover is reached (time or hours whichever occurs first) Option One - Full Machine Coverage Option Two - Powertrain Coverage Option Three - Powertrain plus Hydraulic and Electrical Option Four - Generator sets 24 Months Hours Premium $ Months Hours Premium $ Months Hours Premium $ Months Hours Premium $... CUSTOMER S DECLARATION I declare that to the best of my knowledge and belief that the information provided above is correct. I hereby acknowledge that prior to signing I have read the warranty document and fully understand the YanmarExtended Warranty Programme. CUSTOMER S SIGNATURE:.DATE:. NAME OF DEALERSHIP: NAME OF DEALER REPRESENTATIVE:.. IMPORTANT NOTICE: Cover does not commence until premium (in full) and application form has been received by the Warranty Administrator. WHITE SECURE COPY YELLOW DEALERS COPY BLUE CUSTOMER S COPY

3 EQUIPMENT MASTER PARTS SCHEDULE OPTION ONE FULL MACHINE COVERAGE: Covers the complete machine with the exception of: Component Parts excluded 1. Axles/Drivelines Universal joints, external damage to seals, hoses and fittings, pipes 2. Brake System Hoses, unions, discs, friction and counter plates, brake pads. 3. Electrical System Bulbs, fuses, batteries, lamps, lenses, radios, wire connectors, wiring, lighting, audio/vision alarms, cigars/cigarette lighters, corroded terminals, indicators, damage to alternator or my electrical component resulting from the failure to disconnect the battery during welding or using incorrect jump starting methods. 4. Engine/Fuel System Engine mounts, hoses and fittings, filters, elements, fan belts, pulleys, lubricants antifreeze, burnt and/or pitted valves, injectors, gaskets, exhaust manifold and all exhaust components, throttle and stop cables, adjustments. 5. Hydraulic System Hoses and fittings, orings, couplers, quick connects, filters, external seals, pipes, rubber mountings, hydraulic tank breathers, hydraulic oil. 6. Main Frame/Chassis Impact damage, rollover, pivot pins, bushings, body and paint work, forks front shovel/buckets, toe plates, tow hitches, tow bar, undercarriages extending dipper wear strips, backhoe buckets, including teeth/side cutter, wear pads, loader/backhoe links, carriages, kingpost, hose routing guides deterioration due to use of non factory approved attachments and those items mentioned in the standard exclusions. 7. Steering Hoses, and fittings, steering stops, steering wheel. 8. Transmission All mountings, hoses and fittings, lubricants, filters. 9. Miscellaneous Tyres, wiper blades and arms, glass, seat, seat belts, cab trim, weather strips, rubber seals, handles, locks, hinges, mirrors, wear pads, pivot pins, bushings, hoses, pipes, unions, air condition recharge, expansion valve, driers, freon, filters, chains, deterioration due to use of non-factory approved attachments and those items mentioned in the standard exclusions. 2 EXTENDED WARRANTY POLICY

4 EQUIPMENT MASTER PARTS SCHEDULE OPTION TWO POWERTRAIN COVERAGE: ENGINE Engine Block Cylinder Liners Front & Rear Engine Covers Crankshaft Crankshaft Bearings & Gear Front & Rear Crankshaft Seals Damper Flywheel, Ring Gear Cylinder Heads Rocker Arm Assembly Valve Cover Camshaft Camshaft Bearings Camshaft Drive Gear Timing Gears Accessory Gears Pistons & Rings Connecting Rods & Bearings Water Pump Injection Pump Turbocharger Oil Pump Oil Pan..and all parts within the above systems. Excludes: engine mounts hoses, and fittings, filters, elements, fan belts, pulleys, lubricants, antifreeze, burnt and/or pitted valves, injectors, gaskets, exhaust manifold and all exhaust components, throttle and stop cables, radiator and coolers, adjustments TRANSMISSION Transmission Case Counter Shaft Clutch Clutch Discs (wet only) Clutch Plates (wet only) Internal Wet Service Brakes Transmission Pump Torque Converter Pump Transmission Gears, Bearings & Shafts Torque Converter Wet Steering Clutches Splitter Drive Transfer Drive Hydraulic Transmission- Control Valves Hydrostatic Transmission Charge Pump Hydrostatic Transmission Variable - Displacement Pump Hydrostatic Transmission Rotary Group Internal Transmission Control Linkage and all parts within the above system Excludes: all mountings, hoses, and fittings, oil coolers, wiring harness, lubricants, filters, breathers. Drive Line Drive Shaft Drive Shaft Support Bearing Axle Shaft Excludes: universal joints DIFFERENTIAL/FINAL DRIVE Differential Housing Differential Pinion Gear / Ring Gear Drive Axle Hub Final Drive Planetary Gears Final Drive Pinion Planetary Gear Carrier and all parts contained in the above systems. Excludes: external seals, hoses and fittings, pipes, breathers DIFFERENTIAL / FINAL DRIVE (HYDROSTIC UNITS) Hydraulic Drive Pump Hydraulic Drive/Travel Motor Swing Motor and Swing Gear Box Control Valve (Travel and Swing functions Only). Travel & Swing actions of valve, Excludes Dig Functions EXTENDED WARRANTY POLICY 3

5 EQUIPMENT MASTER PARTS SCHEDULE OPTION THREE POWERTRAIN (as detailed in Option Two) PLUS HYDRAULIC COVERAGE AND ELECTRICAL: (If applicable) Pumps Valves Hydraulic Cylinders Starter motors Alternators Sensors Solenoids Wiring looms Excludes: packing, seals, o-rings and bonded washers, hoses, couplers, filters, quick connects, pipes, breathers, oil. OPTION FOUR Generator sets ENGINE Rocker assembly, including hydraulic followers, inlet and exhaust valves (not burnt valves), springs and guides, cylinder head (not cracks and de-coking), cylinder head gasket (except skim), push rods, camshaft and followers, timing gears and chains, oil pump, pistons and rings, cylinder bores, con rods, gudgeon pins and bearings, crankshaft and bearings, inlet manifold, flywheel and ring gear. ELECTRICAL SYSTEM Starter motor, Alternator set, temperature sensing switch and voltage regulator, Electronic control unit Casings If any of the parts covered fails and this damages the casings, they will also be covered. Working Materials Oils, oil filter and anti-freeze etc are covered only if it is essential to replace them because of the failure of a part, which is covered under this policy. Not necessarily every component is covered by this policy. Those components that are covered are listed above. If they are not listed above it is not covered by this policy. 4 EXTENDED WARRANTY POLICY

6 EXCLUSIONS This certificate does not cover: 1. Losses arising from faulty design or any costs and expenses arising from the recall or inherent design faults, for any reason whatsoever, of the Insured machine. 2. Mechanical breakdown where the fault(s) could be reasonably stated by a qualified engineer appointed by Underwriters, to have existed before the commencement of the policy. Any such pre-existing faults must be rectified before the Underwriter s obligations under the policy can come into effect. 3. Any parts that are replaced at the time of repair which have not actually failed, unless it is correct engineering procedure to do so. 4. Any loss where the hourmeter/tachograph/odometer has been tampered with, altered, disconnected or is not working and has not been reported to an authorised dealer. 5. Any loss or damage to the original components as a result of alteration or modification to the Manufacturers Specification. 6. Machines which are owned temporarily or otherwise (resulting from trade in or acquisition for the purpose of resale) by a business formed for the purpose of selling or servicing construction or agricultural machinery. 7. Machines which are not serviced in accordance with the terms of servicing requirements defined in the Assureds Responsibilities for this Insurance Certificate. 8. Components which are not of defective factory workmanship but which are replaced during the course of repair, unless it is correct engineering procedure to do so; components which have been improperly repaired. 9. Parts which are worn but still within the Manufacturer s tolerance. 10. The gradual reduction in operating performance commensurate with the age of the Insured Machine. This includes but is not limited to gradual loss of engine compression necessitating the repair and/or replacement of valves or piston rings and gradual increase in oil consumption due to normal operating functions. 11. Any loss caused by frost damage, misuse or neglect. 12. Repairs and/or replacements not previously authorised by a franchised dealer. 13. Any loss or damage of whatsoever nature arising directly or indirectly in whole or in part due to any type of accident or to any act or omission which is wilful, unlawful or negligent. 14. Any loss solely due to: a. Wear and tear, gradual deterioration, rust, scale or other deposits. b. Scratching or chipping of painted or polished surfaces. c. Corrosion or deterioration due to chemical or atmospheric conditions or otherwise. 15. Reduced performance or efficiency of the Insured Machine. 16. Penalties for any delay of detention, liquidated damages or any other consequential loss, damage or liability unless expressly covered by this policy. EXTENDED WARRANTY POLICY 5

7 17. Any loss, damage, which in the opinion or a qualified engineer appointed by the Underwriters was caused wholly or partially from lack of maintenance, abuse, and neglect in taking reasonable preventative steps or overloading or over revving or its engine (governor seals must be intact). 18. Liability which attaches by virtue or an agreement but which would not have attached in the absence of the said agreement. 19. Any liability for death, bodily injury or damage or other property or any consequential loss of whatsoever nature arising directly or indirectly from any defect or nature. 20. Any loss, damage or liability, which is claimable under any other existing Insurance, Guarantee, Warranty or Contract Maintenance Agreement and any warrantable defects claimable under the Initial Manufacturer s Warranty. 21. Loss or Damage directly or indirectly occasioned by, happening through or in consequence or war, invasion, acts of foreign enemy, hostilities, (whether war be declared or not) civil war, rebellion, revolution, insurrection, military or usurped power or confiscation or nationalism or requisition or destruction or damage to property by or under any government or public or local authority. 22. a. Loss or destruction of or damage to any property whatsoever or any loss or expense whatsoever resulting or arising there-from or any consequential loss. b. Any legal liability of whatsoever nature directly or indirectly caused by or contributed by or arising from. c. Ionising radiations or contamination by radioactivity from any nuclear fuel or from any nuclear waste from the combustion of nuclear fuel. d. The radioactive, toxic, explosive or other hazardous properties of any explosive nuclear assembly or nuclear component thereof. 23. Loss destruction or damage directly occasioned by pressure waves caused by aircraft or serial devices travelling at sonic or supersonic speeds. 24. Failures caused by fire, collision, accident, theft, vandalism, explosion, chemicals, salt, casualty, or the environment (wind, water, lightning, heat, cold, hail, earthquake), and any other extraneous cause. 25. Expenses associated with routine maintenance and/or replacement or service icons, consumable such as oils, filters, coolants and the like, and normal wear items (unless required to repair a warrantable defect) 26. Costs incurred for the betterment of the Insured Machine or its components. 27. All components NOT listed in the Master Parts Schedule. 28. Premium charges for overtime labour requested by the Assured. 29. Transporting the Insured Machine to and from the place where servicing and/or repairs are performed and service calls made by the repairer. 30. Recurring faults happening within 60 days of one another will not be the responsibility of the Underwriters. 6 EXTENDED WARRANTY POLICY

8 TERMS AND CONDITIONS 1. Subject to terms, conditions and limitations that follow and provided that the Assured has at all times observed the Assureds responsibilities herein then the Franchised Dealer or a repairer authorised by us will repair or replace, as it elects any components of the Insured Machine that experience a warrantable defect within the Territorial Limits during the Indemnity Period, without charge to the Assured parts and labour. Other than any deductible if applicable. 2. As used in this document, warrantable defect means any Electrical, Hydraulic or Mechanical Breakdown shown to be due solely to defective materials or defective factory workmanship necessitating repair and/or replacement in accordance with the conditions of this policy. 3. This policy does not preclude you from exercising your contractual, legal or statutory rights as a customer of the machine retailer nor your rights under the Initial Manufacturer s Warranty. 4. Underwriters shall be entitled on the happening of any loss to undertake in the name and on behalf of the Assured the absolute conduct control and settlement of any proceedings at its own expense and for its own benefit but in the name of the Insured to recover compensation or secure indemnity from any third party in respect of anything covered under the policy. 5. No repairs are to be commenced until authorised by underwriters. 6. Any exploratory dismantling charges will only be reimbursed as part of a valid claim. It is the responsibility of the Assured to authorise dismantling and to pay the charges if such dismantling proves that the failure is not the responsibility of the Insurers. 7. The Assured shall take all reasonable steps to safeguard the Insured Machine from loss or damage and to maintain it in efficient condition. The Insured equipment must be serviced in accordance with the Manufacturer s recommendations and within time of the recommended intervals. 8. If any difference should arise as to the amount to be paid under the policy (liability being otherwise admitted) such difference shall be referred to an arbitrator to be appointed by the parties in accordance with the statutory provisions. Where any difference is by this condition to be referred to arbitration the making of an award shall be a condition precedent to any right of action against Underwriters. 9. The due observance and fulfilment of the terms, conditions and endorsements of the policy by the Insured insofar as they relate to anything to be done or compiled with by the Assured and the truth of the statements and answers contained in the Application Form shall be conditions precedent to any liability of Underwriters to make any payment under the policy. 10. Underwriters shall not be liable in respect of any claim insured by any other existing policy or policies, warranty or guarantee in respect of any excess beyond the amount which is payable under such policy or policies, warranty or guarantee. 11. If any claim is fraudulent in any respect, we may cancel this policy pursuant to the insurance contracts Act. 12. Underwriters shall not be liable for any statements or representation, written or verbal (by whosoever made) which contradicts the Terms and Conditions of the Policy, unless such statement or representations is supported in writing by underwriters on their behalf within the limits specified in the Schedule of this Cover. EXTENDED WARRANTY POLICY 7

9 ASSUREDS RESPONSIBILITIES 1. The Assured at his or her own expense, must maintain, operate and service the Insured Machine as indicated in its Operator s Manual. The Assured must maintain adequate records of the Insured Machine s maintenance and service history, including the use of genuine Manufacturer parts. 2. The Franchised Dealer must fully service and inspect the Insured Machine according to the Schedules and procedures laid down in the operator s manual at the Assureds cost, unless approved in writing by us. 3. Covered repairs must be performed by a Franchised Dealer or a repairer authorized by us. When requesting covered repairs, the Assured must present this Policy and, if requested, records of the Insured Machine s maintenance and service history. TERMINATION OF COVERAGE: Underwriters are relieved of their obligation under the Policy if: 1. Service (other than normal maintenance and replacement of service items ) is performed by someone other than an authorised Dealer (unless approved in writing by Secure Warranty), or 2. The product is alerted or modified in a way not approved by the manufacturer, or 3. The product s hour meter, tachograph or odometer has been rendered inoperative or otherwise tampered with; or 4. The product is removed from the Commonwealth of Australia. 5. If after buying a mechanical breakdown insurance policy from us, you decide that you do not want the policy after all, simply wright to us within 30 days of the inception date and, subject to there not having been a claim, we will cancel all cover. We will refund any premium you have already paid within the period. 6. If you decide to cancel at any time after this initial 30 day period, subject to no reported claims, we will make a pro-rata return of your premium less an administration charge of $ No refund will be provided if a claim has been paid under this policy. TRANSFER OF POLICY UPON RESALE Any unexpired portion of this policy may be transferred to a subsequent Purchaser of the product only if: 1. The subsequent Purchase is made before the Insured Machines Policy Coverage expires. 2. The Product is determined by the Underwriters to be in satisfactory condition following an inspection performed by an authorised Dealer in accordance with the Underwriters instruction at the subsequent purchaser s expense and 3. Transfer documentation, upon forms furnished by your authorised selling Dealer, are properly completed and submitted for confirmation by Underwriters. 4. The transfer fee of $ is paid to Underwriters 8 EXTENDED WARRANTY POLICY

10 5. The Underwriters written confirmation of the transfer is received by the subsequent purchaser. NO IMPLIED WARRANTY Where permitted by law products carry no implied warranty of merchant ability of fitness. CLAIMS PROCEDURES 1. Deductible/excess may apply, please see policy certificate for deductible amount. 2. Contact your Franchised Dealer from whom the machine was purchased or any other Franchised Dealer, to organise an inspection of the Insured machine to ascertain the cause of failure. Please be prepared to hand the following documents to the Franchised Dealer or authorised repairer. a) this Insurance policy and Validation Certificate b) proof of Servicing, including the use of genuine Manufacturer parts 3. The Franchised Dealer or authorised repairer will establish the cause of the breakdown, and check that the component(s) directly causing the failure are covered by this policy. 4. The Franchised Dealer or authorised repairer will be obliged to retain all replaced parts, after settlement of claim or otherwise authorised, for a maximum period of 2 months. 5. The Claims Service will visit Franchised Dealers or authorised repairer on a random basis to inspect damaged parts. 6. The Claims Service reserves the right to examine any Insured Machine and subject the damage to expert assessment before commencement of any repairs and/or replacements within 24 hours of claims notification. It shall be clearly understood and agreed that in the event of any dispute arising as to the extent of the liability of Underwriters the decision of the extent of the liability of Underwriters the decision of the assessor shall be final and binding on both Underwriter and the Assured (being the Insured Machine owner). 7. Following completion of repairs, the completed Claim Form, Invoice, and any supporting documents (this may include the Policy Document) will be forwarded by the authorised repairer to the Claims Service for reimbursement. 8. Where necessary, the Policy Document will be posted back to the Assured following review by the Claims Service: please check they are intact. 9. Any additional costs not insured hereby, or in excess of the terms of your Policy, must be settled directly with the Franchised Dealer or authorised repairer at the time of repair. The Franchised Dealer or authorised repairer forwarding the documentation on your behalf will be deemed to have authority to receive payment direct for the cost of repair and/or replacement. EXTENDED WARRANTY POLICY 9

11 Important notice No repair should be commenced without the authorisation of the Secure Warranty claims department on We will not pay for claims under this contract of insurance where repairs have been carried out without our knowledge and authority number issued. Your Privacy We need to collect, use and disclose your personal information in order to; consider your application for this policy, provide the cover you have chosen, administer the policy and assess any claim. You can choose not to provide us with some of the details or all of your personal information, but this may affect our ability to provide the cover. By providing your personal information to us, you acknowledge and consent that we can collect and use your personal information for placing your warranty policy. You may gain access to your personal information held on record about you by contacting Your duty of disclosure We rely on the information you provide us. You must tell us anything known to you, or that should be known by you, that could affect our decision to cover you. What you must tell us and why: You have a duty under law to tell us anything known to you, and which a reasonable person in the circumstances would include in answering our questions. We will use your answers to decide whether to provide Cover to you, and anyone else named on this policy, and on what terms we will provide cover. Who needs to tell us: It is important you understand you are answering questions for yourself and anyone else named on this Policy. You have the same duty to disclose this information to us before you transfer this policy. If you do not tell us: If you do not answer our questions in this way we may reduce or refuse to pay a claim, or cancel this policy. If you answer our questions fraudulently, we may refuse to pay a claim and treat this policy as never having existed. Complaints Procedure About Lloyd s In Australia, Lloyd s is proud to be a member of the Insurance Council of Australia, and strives to comply with the agreement we have made under the General Insurance Code of Practice. Our aim is to provide the highest service to our Australian policyholders and, to this end, we have developed the following procedures for the fair handling of complaints from Lloyd s policyholders. 10 EXTENDED WARRANTY POLICY

12 How can we help you? There are established procedures for dealing with complaints and disputes regarding your policy or claim. All policyholders can take advantage of the complaints service. Any enquiry or complaint relating to a Lloyd s policy or claim should be addressed to Secure Auto Pty Ltd. Level St Kilda Rd, Melbourne, Vic, 3004, Phone Info@securewarranty.com.au. They will respond to your complaint within 15 business days provided they have all necessary information and have completed any investigation required. Where further information, assessment or investigation is required, they will agree to reasonable alternative timeframes with you. You will also be kept informed of the progress of your complaint. In the unlikely event that this does not resolve the matter or you are not satisfied with the way your complaint has been dealt with, you should contact: Lloyd s Australia Limited Suite 2, Level 21 Angel Place 123 Pitt Street Sydney NSW 2000 Telephone: (02) Facsimile: (02) If your dispute remains unresolved you may be referred to the Financial Ombudsman Service Limited under the terms of the General Insurance Code of Practice. For other disputes you will be referred to other proceedings for resolution. Details are available from Lloyd s Underwriters General Representative in Australia at the address above. The Underwriters accepting this Insurance agree that: (i) If a dispute arises under this Insurance, this Insurance will be subject to Australian law and practice and the Underwriters will submit to the jurisdiction of any competent Court in the Commonwealth of Australia; (ii) Any summons notice or process to be served upon the Underwriters may be served upon: Lloyd s Underwriters General Representative in Australia Suite 2, Level 21 Angel Place 123 Pitt Street Sydney NSW 2000 who has authority to accept service and to appear on the Underwriters behalf; (iii) If a suit is instituted against any of the Underwriters, all Underwriters participating in this Insurance will abide by the final decision of such Court or any competent Appellate Court. How much will this procedure cost you? This service is free of charge to policyholders. EXTENDED WARRANTY POLICY 11

13 SERVICE COUPONS SERVICE No 1 SERVICE No 2 SERVICE No 3 SERVICE No 4 SERVICE No 5 12 EXTENDED WARRANTY POLICY

14 SERVICE No 6 SERVICE No 7 SERVICE No 8 SERVICE No 9 SERVICE No 10 EXTENDED WARRANTY POLICY 13

15 NOTES 14 EXTENDED WARRANTY POLICY

16 NOTES EXTENDED WARRANTY POLICY 15

17 NOTES 16 EXTENDED WARRANTY POLICY

18 Warranty No: WARRANTY TRANSFER REQUEST Should you sell or otherwise dispose of your machine, this warranty is fully transferable. The transfer applies from the date of disposal and is subject to payment of $55.00 (including GST) transfer fee. Please complete this transfer and post within 14 days, with fee to: The Warranty Administrator FIG Ltd, ABN ( ) Telephone: (08) P.O. Box 1532 Toll Free: Osborne Park DC, W.A Fax: (08) I certify that I have sold the machine covered by the above warranty. I wish to transfer the warranty and confirm that the service book has been passed to the new owner. DISPOSING OWNER DETAILS SURNAME (MR/MRS/MS/COMPANY).. GIVEN NAME ADDRESS.. SUBURB/TOWN STATE POSTCODE SERIAL NO SIGNATURE.. HOUR METER READING AT TRANSFER DATE ACQUIRING OWNER DETAILS SURNAME (MR/MRS/MS/COMPANY) GIVEN NAME ADDRESS.. SUBURB/TOWN STATE POSTCODE PHONE NUMBER.. HOUR METER READING AT TRANSFER SERIAL NO. SIGNATURE.. DATE