Reconnecting/Disconnecting The Passenger Side Airbag (SRS) 2018
TO BE FILLED OUT BY THE WORKSHOP THAT CARRIES OUT THE PROCEDURE
| Vehicle model: |
| Chassis number: |
| Registration number: |
| Mileage: |
| Workshop responsible: |
| Date (year-month-day): |
| Town: |
TO BE FILLED OUT BY VEHICLE OWNER
| Vehicle owner: |
| Vehicle owner's address: |
| Post code and town: |
I, the undersigned, confirm that passenger side airbag (SRS) has been connected. I am informed that passenger side airbag (SRS) will work according to the manufacturer's specifications from the date indicated above.
SIGNATURES
| Vehicle owner's signature: |
Workshop manager's signature: |
| Name: |
Name: |