Product Manual
38
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!
10.2.7
WARRANTY FORM (YOU MAY PHOTOCOPY THIS
F
ORM)
!
!
FULL
NAME:
!
!
GEND
ER:
□
M
a
l
e
□
F
e
ma
l
e
!
MM/ DD/
YYYY
/
/
!
DATE
OF
B
I
R
T
H
:
!
!
ADDRESS:
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!
MODEL:
KARMA
KM-B
T10
!
SERIAL
NUMBER:
!
!
MM/ DD/
YYYY
/
/
!
DATE
OF
P
U
RC
H
A
S
E
:
!
!
PURCHASER
SIGNATURE:
!
10.2.8.
DEALER’S
D
A
T
A
!
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!
NAME OF
ST
O
R
E:
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!
TELEPHONE
AND ADDRESS:
!
If you have any
suggestions
on how to improve our products,
please
don’t hesitate to contact your local dealer to let us know what
you
think of your wheelchair. Our contact details are
o
n
http://www.KarmaMedical.com.
Thank you and
enjoy.