Instructions

1. R.O. NUMBER & DATE: The dealership should enter the R.O. Number and Date of the owner's or dealer's paid receipt or invoice.

2. REQUEST DATE (MONTH, DAY): Date owner or dealer requested reimbursement.

3. VEHICLE IDENTIFICATION NUMBER: VIN involved.

4. MILEAGE: Enter mileage at time of transaction. (If not available, enter "O".)

5. FC Code is preprinted on form.

6. LABOR OPERATION NO. - Use T7511.

7 & 8. SUBLET DMN & LINE TOTAL: Enter total amount of
reimbursement. (Do not enter parts or labor hours on claim.)

9. AUTH CODE: If the amount of reimbursement approved is $90 or less, no authorization is needed. If the amount exceeds $90, contact Chevrolet Marketing Center Representative for pre-approval.

10. REQUESTED REIMBURSEMENT: Dealer Service Manager enters amounts determined from owner supplied invoices or paid receipts, which are covered.

11. APPROVED AMOUNT & 740 STAMP: Dealer Service Manager to determine based on reimbursement policy of this bulletin. If the total amount exceeds $90, contact Chevrolet Marketing Center Representative for authorization.

12. See item 11 to determine need for authorization.

13. DEALER REFERENCE INFORMATION:

A. Enter Document Number and Line Number on which claim was submitted.

B. Enter Claim Memo Number and Date when claim is credited.

C. Enter Number of Dealer Check to Owner, if applicable. Date Check was written, if applicable. Date copy of Check was attached to OWNER REQUEST FOR REIMBURSEMENT file.

14. OWNER INFORMATION (must include telephone number).
15. DEALER INFORMATION & SERVICE MANAGER SIGNATURE: To be completed by service Manager.

16. EXPLAIN: Should the Dealer Service Manager determine, after review of owner's invoices/receipts, that the reimbursement case is not eligible; Service Manager should write reason on worksheet, explain to owner, and place a copy of the worksheet in the file.

If the amount approved by the Chevrolet Representative is different from the amount determined by the dealer, the Chevrolet Representative will provide a reason as an explanation to the owner.

17. The Dealer is then to issue the owner a check for reimbursement in the approved amount. A copy of the check issued to the owner is to be attached to the Dealer's file copy of the request within 30 days after Dealer credit is received and retained for 24 months from date of credit.