Tire Registration

First Name*

Last Name*

E-mail*

Phone

Birth Date

Address Line 1

Address Line 2

City*

State/Province*

ZIP/Postal Code

Tire Model*

Tire Size (E.g 265/75R15 Width/Aspect Rim)*

Sale Date*

Quantity*

DOT TIRE NUMBER 1*

DOT TIRE NUMBER 2*

DOT TIRE NUMBER 3*

DOT TIRE NUMBER 4*

Your tire Department of Transportation (DOT) codes located on your dealer registry card or on your tires

Dealer Name*

Address Line 1*

Address Line 2*

City*

State/Province*

ZIP/Postal Code