Warranty

CUSTOMER’S NAME (Please Print)
E-MAIL ADDRESS
DATE OF PURCHASE
CUSTOMER’S ADDRESS
CITY STATE/PROVINCE ZIP/Postal Code
NAME OF DEALER WHICH SOLD TIRE
DEALER’S ADDRESS
CITY STATE/PROVINCE ZIP/Postal Code
TIRE IDENTIFICATION NUMBERS
QTY.
1 2 3 4 5 6 7 8 9
10 11
SHADED AREAS MUST
BE FILLED IN BY SELLER
24
Instead of mailing this form, you can
register online at
www.us.coopertire.com
OMB No. 2127-0050
DO NOT USE THIS SPACE
®
®
®
IMPORTANT
In case of a recall, we can reach you only if we
have your name and address. You MUST send in
this card to be on our recall list.
Do it today.