Proof of Correction Form

COMPLETING THE VEHICLE EMISSION RECALL - PROOF OF CORRECTION FORM


California residents who own an affected vehicle, may be required to send in a Vehicle Emission Recall - Proof of Correction form (MSSF-106D-00) to the California Department of Motor Vehicles (DMV) as evidence of recall completion when they apply for vehicle registration renewal. Each customer whose vehicle is registered within California must be given a completed Vehicle Emission Recall - Proof of Correction form after the recall has been completed. Packages of this form have been sent to California dealers along with this bulletin. Additional forms are available from your facing PDC in packages of 25.

Note: This form MUST be completed by the Dealership's Service Manager using a permanent ink pen. A fine point pen is recommended. When filling in the information, copy the information directly from the vehicle, NOT the repair order. ALL INFORMATION MUST BE PRINTED AND NEAT.

DO NOT COMPLETE THE FORM UNLESS THE RECALL WORK IS COMPLETED!

1. Enter the vehicle's license number.

2. Enter "MITSUBISHI".

3. Enter the vehicle's model year (either "91" or "92" depending on the vehicle you are working on).

4. Enter "ECLIPSE".

5. Enter the Vehicle Identification Number.

NOTE: 1 digit per box, and the digits must be legible. (Use a fine point pen.)

6. Enter "EMR-92-004".

7. Enter your dealership's name.

8. Enter your dealership's physical address. Not the mailing address.

9. Enter date of repair.

10. Sign the form.