Fillable Vehicle Service Contract Transfer Form Transfer Form

VEHICLE SERVICE CONTRACT TRANSFER FORM

Please complete this form and send it to the Administrator (with the appropriate transfer fee), in the event that the

sale of Your Vehicle and the Vehicle Service Contract is to be transferred to the new owner (i.e., Vehicle is sold through

consignment or private party). Please note the following:

1) This transfer CANNOT be made if the title transfer passes through an entity other than the subsequent buyer (i.e.,

the Vehicle is traded in on the purchase of another vehicle at the dealership, leasing agency or entity/individual in the

business of selling automobiles, or in the event of valid repossession by the lienholder). A copy of the “Bill of Sale or

Title Transfer” may be required to complete the transfer.

2) The transfer of the Vehicle Service Contract must be accomplished within thirty (30) days of the sale of Your Vehicle.

3) Any remaining factory warranty MUST also be transferred at the same time. Future claims will be adjusted on the

basis that the remaining factory warranty was transferred, whether or not this was accomplished.

4) All maintenance records showing correct oil changes and factory maintenance must be given to the new owner. These

maintenance records must be retained along with similar documentation for future maintenance work which the new

owner has performed in accordance with the Maintenance Requirements of the Vehicle Service Contract. If necessary,

these documents will be verified by the Administrator at the time a claim occurs.

5) A transfer fee is required and must be submitted with this transfer form. Checks should be made payable to the

Administrator as listed on Your Registration Page.

6) Please check the Transfer Section of the Vehicle Service Contract for Your fee amount and any additional transfer

provisions that may be required by the Contract.

7) This Contract can be transferred only once. This transfer must be initiated by the original Contract Holder.

8) If a balance is owed on this Contract to a premium finance company the original Contract Holder and the subsequent

Contract Holder must make arrangements with the premium finance company to transfer the balance due on this

Contract to the subsequent Contract Holder. This Contract transfer is contingent on the proper registering and

acceptance of the balance transfer with the premium finance company. If the balance transfer is not accepted the

premium finance company may cancel this Contract.

TRANSFER FORM

(Please Print)

(Last 6 digits only)

Contract Number

VIN

Date Vehicle Transferred

Mileage at time of sale

Name of (New) Vehicle Owner

Address

City

State

ZIP Code

Telephone

Purchase Price to New Owner

IMPORTANT NOTE: Coverage will not be effective until the Original Owner signs this form as indicated and the New

Owner receives a notification letter from the Administrator. Call the Administrator if letter does not arrive within thirty

(30) days of submitting this transfer.

By my signature, I hereby verify that the information shown on this form is true, correct and complete.

Original Owner (Print Name)

Telephone

Original Owner (Signature)

Date

I, (New Owner/Print Name)

, a resident of the City of

and State of

, hereby acknowledge that I have been informed

of, understand and agree with the following:

I am currently applying for a transfer of the above referenced Vehicle Service Contract. I understand and agree that as

a condition of the transfer of said Vehicle Service Contract I am responsible for obtaining any and all service records

pertaining to the above referenced vehicle.

I understand and agree that if the vehicle in question was not/is not maintained properly before or after my purchase of

same and/or I fail to obtain service records substantiating that the vehicle in question was maintained properly before

or after my purchase of same, any claims arising in the future may be denied for reimbursement under the condition set

forth in the above referenced Vehicle Service Contract.

I understand and agree that if I have any questions regarding this statement and/or Transfer of the above referenced

Vehicle Service Contract, I can contact the Administrator of same.

I have read this statement, I understand and agree with all the terms, conditions and provisions as set forth in same.

I execute it voluntarily and with full knowledge of its significance.

Your Signature (New Owner)

Date

ATTN: Customer Service Dept/Transfers

P.O. Box 1179

Bedford, TX 76095

Florida Lic # 60082

Toll Free: 1-800-577-6624

67TRNSFR0909

Vehicle Service Contract Transfer Form Transfer Form - Warrantech

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