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For Internal Use Only Certificate of Authenticity Order Form Section 1 Customer Details Title First Name Surname Title Address Address Line 1 Contact Details Telephone 1 Telephone 2 Email Section 2 Vehicle Details Vehicle Identification Number VIN Vehicle Reg. Model Year / Model Type Date and Place of Purchase Still Own Section 3 Payment Details Cost Porsche Club GB Members Free of Charge Non Porsche Club GB Members 65. 00 Payment by Cheque / Postal Order enclosed Copy of Proof of Ownership documents enclosed Club Membership number Please provide any required payment via cheque made out to Porsche Cars Great Britain Limited Send this completed form and payment if applicable with a copy of your proof of vehicle ownership V55 Document or Purchase invoice to the following address Offer limited to personal use only. Certificates for Commercial use charged at 65 per certificate. Porsche Cars Great Britain Limited Bath Road Calcot Reading RG31 7SE or email customer. assistance porsche. co. uk and Fax 01189 165 199. For further information please call 01189 191 744. Please allow 2 weeks for processing of your Certificate of Authenticity to be delivered to your address - as above. Signature Print Name Date Porsche Privacy Commitment We feel strongly about protecting your privacy so your information will be held by Porsche Cars Great Britain Limited in accordance with the Data Protection Act 1998. Information we hold about you may be used for research and analysis or to contact you with relevant offers invitations or information about our products services or events. We may contact you by mail telephone fax SMS or e-mail if you have provided the relevant information* Your information will only be used by Porsche this includes Porsche Cars Great Britain Limited Porsche Centres our associated companies or agents. Please tick this box if you do NOT wish to be contacted by Porsche. To access or update your information please call 08457 911 911. 00 Payment by Cheque / Postal Order enclosed Copy of Proof of Ownership documents enclosed Club Membership number Please provide any required payment via cheque made out to Porsche Cars Great Britain Limited Send this completed form and payment if applicable with a copy of your proof of vehicle ownership V55 Document or Purchase invoice to the following address Offer limited to personal use only. Certificates for Commercial use charged at 65 per certificate. Porsche Cars Great Britain Limited Bath Road Calcot Reading RG31 7SE or email customer. Certificates for Commercial use charged at 65 per certificate. Porsche Cars Great Britain Limited Bath Road Calcot Reading RG31 7SE or email customer. assistance porsche. co. uk and Fax 01189 165 199. For further information please call 01189 191 744. assistance porsche. co. uk and Fax 01189 165 199. For further information please call 01189 191 744. Please allow 2 weeks for processing of your Certificate of Authenticity to be delivered to your address - as above. Please allow 2 weeks for processing of your Certificate of Authenticity to be delivered to your address - as above. Signature Print Name Date Porsche Privacy Commitment We feel strongly about protecting your privacy so your information will be held by Porsche Cars Great Britain Limited in accordance with the Data Protection Act 1998. .

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