Date*:
Dealer Name*:
Customer Details: Name*:
Company Name:
Contact Person*:
Address*:
Zip Code / City*:
Phone*:
Mobile:
Email*:
Please contact the customer by phone to go through the settings in the following time slot*: — Please choose —Morning 09-12hAfternoon 13-17hEvening 19-21hNo preference
Tracker Model*: — Please choose —Wired: Navirec EASYWired: Navirec FLEETWired: Navirec HEAVY DUTYWired: Navirec OBD CAN+Wired: Navirec PRO EXPERTWired: Navirec SMARTWireless: SOLO
Imeicode*:
Object License Plate*:
Object Chassis Number*:
Object Description:
Installation Date*:
Filled in by*:
* = Mandatory fields
