January 2005
132000-04-005
EMERGENCY INFORMATION
YOUR WINNEBAGO INDUSTRIES DEALER
Name ____________________________________________________________________________
Address __________________________________________________________________________
_________________________________________________________________________________
Contact Person _____________________________________________________________________
Phone ____________________________________________________________________________
CHASSIS DEALER/SERVICE CENTER
Name ____________________________________________________________________________
Address __________________________________________________________________________
_________________________________________________________________________________
Contact Person _____________________________________________________________________
Phone ____________________________________________________________________________
INSURANCE POLICY
Company _________________________________________________________________________
Policy Number _____________________________________________________________________
Phone ____________________________________________________________________________
OWNER’S NAME
STREET ADDRESS
CITY AND STATE (OR PROVINCE IN CANADA)
MOTOR HOME SERIAL NUMBER
VEHICLE CHASSIS IDENTIFICATION NO. (VIN)
DATE OF DELIVERY TO FIRST RETAIL PURCHASER
VEHICLE MILEAGE AT TIME OF DELIVERY
SELLING DEALER NAME AND ADDRESS