Attachment IV

Attachment IV Page 1 of 1

Modifications performed for Emissions Recall 87E63 Steps F and K must be submitted on Claim Forms 1864.

REPORTING COMPLETIONS

Only the Form 1864 will be accepted for reimbursement for the Emissions Recall 87E63 portion of this program. The Form 1864 must be completely filled out and signed by authorized dealer personnel.

CLAIMS

The claims must be entered through the Direct Warranty Entry (DWE) system. Dealers without DWE capability must mail the second copy of the Form 1864 for reimbursement. Should your dealership receive pre-printed Forms 1864 with a seven digit claim number, you must drop the first digit and enter only the last six digits. You must sight verify the claim number for accuracy. It is important that all claims be filled for all completed units so that you will be reimbursed and our records will show completion.

SCHEDULED
LABOR OPERATIONS TIME (HOURS)
Rework Throttle Body, Check A/C Diode Continuity, Replace Speed Sensor, Replace Electronic Engine Control Module, Attach Vehicle Emissions Control Information (VECI) and Calibration Code Decals, and Prepare and Attach Authorized Modifications Decals . . . . . . . . . . . . . . . . . 2.8 Insert in Box "B" of Form 1864
Administrative Allowance . . . . . . . . . . . . . . . 0.1

The 0.1 hour administrative allowance must be added before inserting the total labor time in Box "B" of the Form 1864.