First Name
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Last Name
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Email
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Phone
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Address
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City
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State
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Postal code
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Original Dealer Name
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Purchase Date / Warranty Start Date
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Brand of Cart and Model
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ICON i20
ICON i20UL
ICON i40
ICON i40L
ICON i40F
ICON i40FL
ICON i60
ICON i60L
Epic E20
Epic E40
Epic E40L
Epic E40FL
Epic E60
Epic E60L
Evolution Classic 4 Pro
Evolution Classic 4 Plus
Evolution Forester 4 Plus
Evolution Forester 6 Plus
Atlas Go 4 Passenger
Atlas Go 4 Passenger Lifted
Star Sirius 2+2
Star Sirius 2+2 Lifted
Star Sirius 4+2 Lifted
Star Capella 2+2
Star Capella 2+2 Lifted
Other - Please state brand and model
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Cart Color
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Chasis / LTA / Serial#
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Cart Miles or Cart Hours
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Service Needed (Please explain with as much detail as possible)
Part Needed (if you are only requesting parts)
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