| Ride-on Tyre Treatment Record |
| Date of Purchase |
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| Address |
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| Customer Name |
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| City |
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| State |
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| Pin |
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| Vehicle Make & Model |
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| Vehicle Identification Number |
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| Product Registration Form |
| Customer Name |
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| Address |
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| Telephone (Res.) |
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| E-mail |
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| Vehicle Details |
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| Vehicle Registration No. |
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| Make |
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| Model |
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| Year |
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| Tyre Details/Brand |
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| Age of Tyres |
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| How many puctures if any |
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| Tube Details |
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| Age of Tubes |
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| No of Punctures |
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| No of Patches |
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| Ride-On Dealer Details |
| Name |
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| Address |
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| City |
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| State |
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| Phone No. |
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| Kindly answer these questions to help us SERVER YOU BETTER |
| Where did you hear about RIDE-ON TPS |
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| Did dealer explain the product to you |
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| How much did you pay |
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| No. of Tyres treated |
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| How many ounces in each tyre |
|
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