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General Terms & Conditions Sale



  1. Contract Terms
    • Please read these Conditions carefully as they set out the terms on which we agree to sell you Goods. These Terms apply to the Contract (as defined below) between you and us to the exclusion of any other terms that you seek to impose or incorporate, or which are implied by trade, custom, practice or course of dealing. We may revise these Conditions at any time by updating the terms on this website. You should check this website from time to time to review the then current Conditions.
    • The following definitions apply:

"Business Customer" means a person other than a Consumer, including a person acting for purposes relating to that person’s trade, business, craft or profession;

"Conditions" means these terms and conditions, the International Special Terms and Conditions and the Special Conditions;

"Consumer" means a consumer as defined in the Consumer Rights Act 2015;

"Contract" means the contract for the sale of Goods between us and you, which consists of the Order and these Conditions;

"Event Outside Our Control" means any event beyond our reasonable control, including (without limitation) delay or non-supply by the Goods manufacturer or other third party supplier of the Goods, damage or faults to the Goods caused prior to its delivery to you or by a third party, failure by the manufacturer to authorise delivery of the Goods, strikes or other industrial action, civil commotion, riot, invasion, terrorist attack or threat of such attack, war (declared or not), fire, explosion, storm, flood, earthquake or other natural disaster, epidemic or pandemic, failure of public or private telecommunications networks or impossibility of the use of railway, shipping, aircraft, motor or other means of public or private transport;

"Goods" means the vehicle, parts or accessories displayed for sale on this website and stated in the Order;

"Goods’ Description" means that part of the website where certain terms and conditions in respect of individual Goods are provided;

"Order" means the order agreed between you and us;

"Special Conditions" means the terms and conditions in the Goods’ Description;

"We/us" means Vertu Motors plc (company number 05984855) or one of its group or affiliate companies whose registered office is at Vertu House, Fifth Avenue Business Park, Team Valley, Gateshead, NE11 0XA; and

"You" means a user of this website.


2.              Contract Creation and Electronic Contracting

  • The technical steps required to create the Contract are set out below:
  • You place the Order for your Goods on the website by pressing the confirm order button at the end of the checkout process. You will be guided through the process of placing an order by a series of simple instructions on the website and as part of our checkout process you will be given the opportunity to check your order and to correct any errors.
  • We may send you an order acknowledgement email as soon as you place your order, and you will receive an order confirmation email detailing the Goods you have ordered. These emails do not constitute acceptance of your Order.
  • For items being delivered to you (as opposed to click & collect), when your product is shipped from our premises, we will send you a despatch confirmation email.
  • Order acceptance and the completion of the Contract will take place on the despatch to you of the Goods ordered unless we have notified you that we do not accept your Order.
  • For most Goods sent directly from our premises, your credit/debit card/payment account will be charged when your Order is placed.
  • If the Goods are being delivered direct to you from a supplier, for instance in the case of larger products, you may be charged at any point between confirmation of your Order and despatch. The exact timing of this will vary according to supplier and the product you're ordering.
    • Non-acceptance of an Order by us may be a result of one of the following:
  • The Goods you ordered being unavailable from stock.
  • Our inability to obtain authorisation for your payment.
  • The identification of a pricing or product description error.
  • If you do not meet any eligibility criteria set out in the Conditions.
  • If you are placing an order for an item that by law is age-restricted, then by clicking the order confirm button you are also confirming to us that you are of at least the legal age required to purchase the product. By clicking the order confirm button, you further acknowledge and consent to us taking steps to verify your age by reference to publicly-available third-party sources.  We reserve the right not to supply any age-restricted product where we reasonably believe that you are below the relevant minimum age. 
  • All age-restricted goods must be received by a person who is at least 18 years old at the time of delivery or click & collect handover. We require this regardless of the relevant age limit for the age-restricted product.
  • We reserve the right to request proof of age identification from you if your order contains age-restricted goods, and we are unsure that you are at least 18 years old at the point of delivery or at the point of click & collect handover. For the delivery or handover of all age-restricted goods, we operate on a Challenge 25 basis, which means that if we think you look under the age of 25, we will ask you to show us proof of age identification. If you are asked for proof of age identification and are unable to provide us with any, we reserve the right to withhold the delivery or click & collect the Order.
  • We reserve the right to limit the number of a given item that can be bought by an individual customer should we deem it appropriate. We also reserve the right to suspend your account and any associated accounts and contact you if we notice an unusual pattern of returns activity or there is other suspicious activity associated with your account or any associated accounts. In the event that this happens you will receive an email notifying you of this
  • Should we have taken payment prior to non-acceptance of your Order then we will refund you, but please note that it can take up to 5 days for the bank to transfer the funds to you.


  1. Description, Availability and Price
    • The description and price of, and delivery options for, the Goods will be as shown on the website or marketplace listing at the time you place your Order.
    • The Goods are subject to availability. If on receipt of your Order the Goods are not available in stock, we will inform you as soon as possible and refund or re-credit you for any sum that has been paid by you or debited from your credit or debit card or payment account for the Goods.
    • Every effort is made to ensure that prices shown on the website or marketplace listings are accurate at the time you place your Order. If an error is identified, we will inform you as soon as possible and offer you the option of reconfirming your Order at the correct price or cancelling your Order.  If we do not receive an Order confirmation within 14 days of informing you of the error, the Order will be cancelled automatically.  If you cancel, we will refund or re-credit you for any sum that has been paid by you or debited from your credit or debit card or payment account for the Goods.
    • In addition to the price, you may be required to pay a delivery charge for the Goods.
    • The price includes UK VAT, unless otherwise stated but excludes any other local taxes or customs charges or import duties that may apply. Where you are purchasing outside of the United Kingdom, you will be responsible for all taxes, fees, customs duty, levies or other local charges.


  1. Payment
    • Payment for the Goods and any delivery charges can be made by any method shown on our website or marketplace listing at the time you place your Order (ordinarily by cash, credit or debit card or payment account (subject to limits set by us from time to time) or electronic transfer of funds to our bank account).
    • We must have received cash or cleared funds in our bank account in respect of the price before delivery can take place and timing for payment shall be of the essence. There will be no delivery until cleared funds are received.
    • Payments must be made by you without any deduction whether by way of set-off, counterclaim, discount, abatement or otherwise unless you have a valid court order requiring an amount equal to such deduction to be paid by us to you.
    • We are entitled to use any payment made by you in respect of any goods in settlement of any outstanding invoices or accounts as we in our absolute discretion think fit, notwithstanding any purported purpose indicated by you.
    • We are entitled to recover payment for the Goods notwithstanding that ownership may not have passed from us.


  1. Delivery/Faults
    • Time of delivery will not be of the essence. We will endeavour to deliver the Goods as agreed under the Contract within the time agreed or if no time has been specifically agreed, within a reasonable time following the date that your Order is accepted. In no circumstances will we be liable for loss or damage of any kind caused directly or indirectly by any delay in the delivery of the Goods.
    • Where the Contract is for multiple Goods, we may make delivery by instalments.
    • The Goods may be delivered by us in advance of the quoted delivery date.
    • Delivery will be made at the address you gave and confirmed in the Order.
    • We will endeavour to ensure Orders placed before 12:00 pm on a working day will be processed that day and will be delivered as per the requested delivery option, provided no additional security, customs, import or export checks are required and all stock items are available (a working day being any day other than Saturday or Sunday and bank or other public holidays).
    • Special Delivery Orders placed after 4.30pm on a Friday or on a non-working day will be despatched on the next working day for delivery the following working day. Tracked 24 & Tracked 48 Delivery Services are not guaranteed. Please also note that Special Delivery Services are not Guaranteed over non-working days and Bank Holidays.
    • Please check the Goods carefully on delivery. If you wish to claim for damage or shortfalls in the delivery or that the Goods do not materially comply with their description, then you must advise us in writing within 7 days of delivery. Failure to provide written notice within 7 days may result in your claim being denied.
    • You must notify us within 30 days of despatch if you have not received your goods. Please contact us within this period of time in order for us to be able to assist and resolve your query.
    • Returns for credit will not be accepted without our prior written consent and either a claim under a manufacturer's warranty is involved or the parts are incorrect and not in compliance with the Order or we expressly agrees to accept the returns for credit subject to the our administration/handling charge of 20% of the price (excluding VAT).
    • Any returns for credit must be made within 14 days quoting the invoice/Order number.
    • Goods supplied to your special order or where they are specific to an individual vehicle (such as coded keys) will not be accepted for credit unless they are defective.
    • Any returned Goods must be delivered to us unused, in their original packaging and in good and resalable condition, save in respect of damaged Goods returned in accordance with clause 5.7. If this is not the case we are entitled to deduct a fair and reasonable amount to reflect the condition of the returned Goods and you will receive only a partial refund or no refund at all.
    • Any surcharge in the price of Goods because your old part is not available for exchange at the time of sale will only be credited or refunded if an old part conforming to the re-conditioning requirement is returned to us within 28 days of supply of the Goods.
    • Where you deal as a Consumer you may be able to cancel the Order under Clause 9.1.
    • This clause 5 does not affect your rights under any warranty or guarantee provided by us or Goods manufacturer.
    • If you are a Consumer, your legal rights in relation to the Goods if they are faulty or not as described, are not affected by these Conditions or any warranty or guarantee for the Goods. Advice about your legal rights is available from your local Citizens’ Advice Bureau or Trading Standards Office.


  1. Parts and Accessories Guarantee

We will transfer to you the benefit of any warranty or guarantee given by the manufacturer of the Goods.  For added peace of mind you get a FREE warranty of up to 12 months with certain parts and accessories bought from us via the website or over the phone.  Different warranties apply to different products and the item specific warranty will be detailed with each individual product in the Goods Description.


  1. Liability
    • We will not be liable or responsible for any failure or delay in supplying Goods or services or performing any of our obligations under the Contract if this is caused by an Event Outside Our Control. We may cancel the Contract by giving written notice to you and we will return any monies paid by you.  You will however remain liable to pay for any work done prior to the date of cancellation. 
    • To the fullest extent permitted by law, we will have no liability under the Contract for any loss which is not foreseeable (that is if it was an obvious consequence of our breach or if it was contemplated by both parties at the time of entering into the Contract), and, we shall have no liability for any loss of profit, loss of revenue, sales, earnings and/or income, loss of business, loss of savings, business interruption or loss of business opportunity (irrespective of whether such losses are direct or indirect).
    • We do not in any way exclude or limit liability for: a) death or personal injury caused by our negligence; (b) fraud or fraudulent misrepresentation; or (c) any matter in respect of which it would be unlawful for us to limit liability and, where you are dealing as a Consumer, (i) any breach of the terms implied by section 17 of the Consumer Rights Act 2015 (right to supply goods and quiet possession); (ii) any breach of the terms implied by sections 9 to 14 of the Consumer Rights Act 2015 (satisfactory quality, fitness for purpose, description, pre-contract information, samples/models); (iii) any breach of the Terms implied by sections 49 – 52 of the Consumer Rights Act 2015 (reasonable care and skill, information, reasonable price and reasonable time); or (iv) defective products under the Consumer Protection Act 1987.
    • If you are a Business Customer and you become aware within the first six months after delivery, that the Goods (or any part of them) are not as described in the Order or, has a defect in design, material or workmanship that was present on delivery, then you must notify us within 5 days of: (i) delivery, or if later, (ii) the issue becoming apparent. We will, at its option, repair or replace the Goods.  If we are unable to repair or replace within a reasonable period (taking into account the nature of the issue), then either party can terminate the Contract and the Goods must be returned to us and we will refund the purchase price, less a reasonable amount in respect of the use which you have made of the Goods.  We will not be liable to replace, repair or give a refund where: (i) the defect was not present on delivery; (ii) the defect has arisen as a result of fair wear and tear, wilful damage or negligence (with the exception of the wilful damage or negligence of us); or (iii) you or a third party on your instructions have altered or repaired the Goods without our written consent.
    • If you are a Business Customer: (i) except as provided in this clause 5, we shall have no liability to you in respect of Goods which do not match their description in the Order or which has a defect of design, material or workmanship, and in particular shall have no liability for any such failing first notified to us more than 6 months after collection or delivery; and (ii) the terms implied by sections 13 to 15 of the Sale of Goods Act 1979 are, to the fullest extent permitted by law, excluded from the Contract.


  1. Ownership And Risk
    • The risk of loss or damage to the Goods passes to you on delivery to you or to a person nominated by you to take delivery or on collection by you (as the case may be).
    • The Goods will be owned by you when we have received payment of:
      • the purchase price in full (in cash or cleared funds);
      • all other applicable delivery and other charges; and
      • all other sums which are or which become due to us from you on any account

and the Goods have been delivered/collected (as the case may be).

  • Until ownership of the Goods passes to you, you will:
    • hold the Goods on our behalf;
    • store the Goods at your own cost separately from all other products in your possession including goods of any third party in such a way that they remain readily identifiable as our property;
    • not conceal, obliterate or obscure any mark placed on the Goods or packaging so as to be clearly identifiable as our property;
    • maintain the Goods in satisfactory condition and keep them insured on our behalf for their full price against all risks to our reasonable satisfaction. On request, you shall produce the policy of insurance to us; and
    • hold the proceeds of the insurance referred to above on trust for us and not mix them with any other money, nor pay the proceeds into an overdrawn bank account.
  • We will be entitled at any time after payment for the Goods has become due to repossess the Goods and remove it to the our premises. You grant us an irrevocable licence to enter any of your premises for the purpose of inspecting or repossessing the Goods.
  • If you re-sell the Goods before ownership in the Goods passes to you, you will account to us for all the proceeds of any re-sale and before paying such proceeds to us, you will hold the proceeds on our behalf and keep it separate from your other money.


  1. Cancellation and Failed Delivery
    • Where you deal as a Consumer you may give us notice that you wish to cancel the Contract without giving any reason for doing so within 14 working days of the date of delivery of the Goods to you, unless the Goods are being built to, adapted or converted to your specification, or are consumable and have been opened in which case this right to cancel does not apply. If you wish to exercise this right, you must send written confirmation by email or letter to us. You can choose, but do not have, to use the cancellation form at the end of these Conditions when providing us with your written notice of cancellation.
    • If you cancel the Contract under clause 9.1, then we will reimburse any monies paid by you as soon as reasonably possible and in any event within 14 days of receiving your written notice of cancellation where the Goods have not been delivered or where they have been delivered, within 14 days of you returning the Goods to us. The reimbursement will be made using the same means of payment as you used to pay us unless you have expressly agreed otherwise. In any event, you will not incur any fees as a result of the reimbursement.
    • If the Goods have been delivered to you, you must take reasonable care of them while in your possession. If you cancel the Contract under clause 9.1, you will be responsible for any loss or damage from when you took delivery of the Goods to when we receive them back. You will be responsible for returning the Goods to us at your own cost to the address given. 
    • The Goods, if returned, must be delivered to us unused, in their original packaging and in good and resalable condition. If this is not the case we are entitled to deduct a fair and reasonable amount to reflect the condition of the returned Goods and you will receive only a partial refund or no refund at all.
    • If delivery cannot be made to your address for reasons within our control, we may cancel the Contract by informing you as soon as possible and will refund, or re-credit you, for any sum that has been paid by you, or debited from your credit or debit card including delivery costs.
    • If you fail to take delivery of the goods, we will be entitled without giving formal written notice to you, without prejudice to any other right or remedy available, to:
      • cancel the Contract;
      • cancel or suspend delivery;
      • store the goods until actual delivery;
      • re-sell the parts at the best readily obtainable price to a 3rd party;
      • charge you for the loss suffered including any expenses incurred for failed delivery, selling costs and reasonable storage costs.
    • We will refund or re-credit you within 30 days for any sum that has been paid by you or debited from your credit or debit card for the Goods less the charge for the loss suffered.
    • If there is a failure or delay by the Seller in supplying the Goods or performing any of its obligations under the Contract, that is caused by an Event Outside Our Control, the Seller may cancel the Contract by giving written notice to you and will refund, or re-credit you, for any sum that has been paid by you, or debited from your credit or debit card including delivery costs. You will remain liable to pay for Goods delivered prior to the date of cancellation.
    • Can I exchange an item?

Yes, if the item is returned to us in an unopened, unused condition and the Goods have not been built to, adapted or converted to your specification we will happily exchange the item. Once we receive the original item back we will dispatch the exchange item the same working day.

  • Will my postage cost be refunded?

We will only refund your postage costs if you return the Goods to us because of an error on our part.  Upon receipt of the returned item we will refund reasonable postage costs.

  • Overseas Returns

PLEASE NOTE: when returning an item from overseas please ensure that all paperwork is completed correctly, stating the item is a return.  If this information is missing, we may incur customs charges so unfortunately we will have to refuse the return of the item.


  1. Disclaimers
    • Legal use - the goods, parts and accessories offered by us are only intended for use in a legal manner. It is the sole responsibility of you (and not us) to ascertain and obey all laws which apply to the possession and use of any item from us. You are advised to consult all relevant national laws and regulations before placing an Order. By placing an Order, you represent that you are of legal age and that the products ordered will only be used in a lawful manner. You agree that you will not use or allow others to use any item from us illegally. You further agree to indemnify and hold us harmless for claims, actions, and legal and/or court fees brought against us in connection with any use of items delivered.
    • High Wattage Bulbs and LEDs - if you use your vehicle for off road, display or racing purposes, higher wattage bulbs and LEDs are available for sale:
  • LED bulbs are not road legal as they cannot be E-marked however, this does not apply if your vehicle has LEDs fitted by the vehicle manufacturer.
  • Higher wattage bulbs are not road legal.
  • LED bulbs and high wattage bulbs are sold solely for off-road use only.

In addition, care should always be exercised when increasing power consumption with 100w bulbs, as most vehicles are fitted with 55w bulbs as standard.

  • Goods fit and sufficient for intended use - it is the sole responsibility of you (and not us) to ascertain and determine the appropriateness of the Goods for your required use, including without limitation their application for your specific vehicle, based on the information provided on the website or marketplace listing at the time you place your Order.  The search tool on the website or marketplace is designed for UK vehicle specification.  Application for a specific vehicle including date ranges and right-hand or left-hand drive may vary for vehicles manufactured in different countries.  If you are unsure please contact us.  By placing an Order you acknowledge and represent that you have determined that the Goods will meet your requirements, your vehicle and your intended use.


  1. Complaints
    • If you have any questions about the Goods, please contact us.
    • Where you have a complaint or dispute with us, we operate our own complaints handling procedure. For full details of this procedure, please see our website under “Complaints and Concerns”.
    • In the event of us not being able to resolve the matter, and where you are dealing as a Consumer, you have a right to complain to the following CTSI certified alternative dispute resolution providers that deal with motor industry complaints: The Motor Ombudsman (themotorombudsman.org) or the National Conciliation Service (nationalconciliationservice.co.uk).
    • The Seller confirms that it will engage with an alternative dispute resolution procedure operated by these providers.


  1. Termination
    • The Contract will terminate immediately on the happening of any of the following events:
      • if you become unable to pay your debts when they fall due or proceedings are or are reasonably likely to be commenced by or against you alleging bankruptcy or insolvency or an administrator, receiver or administrative receiver is appointed or is reasonably likely to be appointed over all or part of your undertaking and assets.
      • we serve written notice on you that you have failed to observe or perform any of your obligations or duties under this or any other Contract with us.
    • Termination of the Contract will be without prejudice to the rights, obligations and liabilities of either party already accrued.


  1. General
    • We can assign, sub-contract or sub-let the Contract or any part of it.
    • The Contract shall be governed by and construed in accordance with English law and it is agreed that the courts of England and Wales shall have exclusive jurisdiction to settle any dispute or claim (including non-contractual disputes or claims) arising out of or in connection with this agreement or its subject matter or formation.
    • Any formal notices to us should be sent to our registered office. If we need to give you formal notice, this will be by email or by post to the address in the Order or that we otherwise hold for you.
    • No person who is not a party to the Contract between us acquires any benefit or right under the Contract.
    • If either party gives up their rights or remedies on one occasion that does not mean that they are doing so in respect of any other rights or remedies.
    • If any provision of the Contract is held to be illegal, invalid or unenforceable in whole or in part, that provision will to that extent necessary be deemed to not form part of the Contract and the legality, validity and enforceability of the remainder will not be affected.


  1. International Special Terms and Conditions
    • These additional terms and conditions will apply to all orders for Goods which are being delivered outside of the UK.
    • Definitions

"EU" means any country or territory in the fiscal (VAT) area of the European Community for the avoidance of doubt excluding the UK.

"Non - EU Countries" means Switzerland, Norway and any other country or territory not within the fiscal (VAT) area of the European Community.

  • Payment and VAT
    • We currently only accept payment in Pound sterling, Euro, Australian Dollar, United States Dollar and Canadian Dollar. We are unable to offer the option to pay in any other local currency.  International credit card providers or banks will determine the exchange rate; if payment is made in a currency not issued as standard by the bank, they may add an additional processing or administration charge which the cardholder will be liable to pay.
    • Our delivery charge will be itemised as ‘delivery’ on the delivery and order confirmation pages of the website and in emails from us, after the subtotal for the value of the Goods purchased.
    • The total price you pay to us for the Goods is always the same.
    • VAT (or its equivalent tax) will depend on the country of delivery and will be applied as follows:

Australia - The price includes Australian GST unless otherwise stated but excludes any other local taxes or customs charges or import duties that may apply.  Any such charges will be your responsibility and will not be paid by the Seller.

EU - The price includes VAT in the destination EU country unless otherwise stated but excludes any other local taxes or customs charges or import duties that may apply.  Any such charges will be your responsibility and will not be paid by the Seller.

UK - The price includes UK VAT.

All Other Countries - The Goods and the delivery service will normally be zero-rated i.e. not subject to VAT (or its equivalent tax).  However, the price paid by you for the Goods and/or the delivery service will remain the same but excludes any other local taxes or customs charges or import duties that may apply.  Any such charges will be your responsibility and will not be paid by the Seller.  As no VAT (or its equivalent tax) has been charged there is no tax to reclaim from us.

  • Import Duty Tax Payments and Customs
    • Goods delivered to destinations outside the UK may be subject to taxes, fees, customs duty, levies or other charges once the Goods reach your country as a result of local legislation or customs formalities. The recipient of the Goods is responsible for all customs formalities for the import of the Goods and will be required to pay any additional charges for international delivery, including import duty, formal customs entry, taxes, levies and other charges that may be levied outside the UK. The recipient of the Goods, not the person placing the order, will typically receive a separate request for payment of these charges when the goods arrive in the country of destination. If you are ordering Goods to be delivered to someone else, please ensure they are aware that they will be responsible for these additional charges.
    • Please note that in some countries, such as the USA and Canada, the person ordering Goods may receive a request for payment of these charges, in which case you will be responsible for paying these additional charges. Payment by you or the recipient (as applicable) must be received by the relevant customs authority before delivery of the Goods will be made.
    • Unfortunately, we have no control over these charges and cannot predict what they may be, so we are unable to offer any assistance on these processes. We advise that you check the import charges applicable in any country outside the UK before ordering Goods to be delivered there.
    • You (or the recipient of the Goods if different) will be the importer for all international deliveries of the Goods. Therefore, before placing an Order, it is your responsibility to check that any Goods ordered comply with country, state and/or federal government import regulations, and that there are no local requirements or restrictions which may affect receipt of your Order.
    • You agree that we will act on your behalf as exporter of the Goods and will complete export declarations in our own name on your behalf.
    • Deliveries of Goods to destinations outside the UK may be subject to cross-border inspections by customs authorities. We advise that you check any customs formalities in any country outside the UK before ordering Goods to be delivered there. We will use commercially reasonable efforts to provide you with information which we hold which relates to the Goods or order which you may need in order to arrange customs clearance however you must meet any additional charges for customs clearance.
    • Where possible, we or our subcontractors, will carry out all customs formalities on behalf of the recipient of the Goods. We or our subcontractors, will request payment for these charges from the recipient of the Goods in a separate invoice. We may also request information from you in relation to customs formalities. You must respond to any request for information within 5 days of the request, or the order will be cancelled, and the Goods returned to our warehouse.
    • If an Order is placed and restrictions that we were not aware of at the time the Order was made are applied by the customs authority of the destination country, then we will cancel the Order and return payment to you.
    • If the recipient wishes to return the Goods, they must request a refund of the customs duties and any tax directly with their local customs office and must present proof of return.
  • International Delivery Charges and VAT
    • The website will confirm our charge to deliver your Goods to an international address before you place your Order for the international delivery service.
    • The total price you pay us for the delivery services is always the same, regardless of whether or not UK VAT or an equivalent tax in your country is chargeable on the delivery service.
    • Applicable tax applying to delivery charges will depend on the country of delivery and will apply in accordance with the above paragraph (Payment and VAT).





To: All Car Parts Limited


I hereby give notice that I cancel my contract for the sale of the GOODS below:


Product Description:                                   Ordered on:                                     Delivered on:


Name of Consumer:                                      Address of Consumer:




Signature:                                                          Date: