CLOSER TO RALLY. RALLY GUIDE 2 APPENDIX 5 FORMS FEBRUARY 2017 RALLYSWEDEN.COM #RALLYSWEDEN

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1 RALLY GUIDE APPENDIX 5 FORMS FEBRUARY 2017 RALLYSWEDEN.COM #RALLYSWEDEN

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3 APPENDIX 5 - FORMS CLOSER TO RALLY. 1. EVENT FUEL PURCHASE ORDER FORM MICHELIN TYRES ORDER FORM HELICOPTER REGISTRATION FORM DRONE REGISTRATION FORM RECCE REGISTRATION FORM ADDITIONAL MATERIALS ORDER FORM SERVICE PARK FACILITIES ORDER FORM RECCE APLICATION FOR NON-ENTRANTS

4 1. EVENT FUEL PURCHASE ORDER FORM FUEL ORDER FORM WRC 2017 RACE: TEAM: DRIVER AND NUMBER PANTA MAX WRC RON LT DRUMS FUEL DISPENSED (SHAKE DOWN) PRICE PER LITRE: 5,00 + VAT PLEASE NOTE THAT: In Italy 22% VAT is applicable to all Competitors. In France 20% VAT is applicable to all Competitors with the exception of French Teams. In Spain 21% VAT is applicable to all Competitors. For all the other European destinations, 22% VAT is applicable only to Private Citizens, Italian Companies and non- European Union Companies. For long haul events no VAT is applicable. DETAILS FOR INVOICING COMPANY NAME VAT CODE ADDRESS CONTACTS STREET CITY POST CODE PHONE FAX MOBILE CONTACT PERSON NAME E.MAIL pag. 1 4

5 PAYMENT Bank transfer ( please attach a copy) Account Owner: PANTA DISTRIBUZIONE S.p.A. Bank: BANCA POPOLARE DI SONDRIO IBAN Code: IT58U X34 BIC=SWIFT CODE: POSOIT22 Credit Card (only VISA or MASTERCARD) Number: Expiry date: Holder: Signature: DEADLINES EUROPEAN EVENTS: 2 WEEKS BEFORE THE EVENT LONG HAUL EVENTS: 6 WEEKS BEFORE THE EVENTS AFTER DEADLINES THE ORDERS ARE NOT GUARANTEE PLEASE RETURN THIS FORM TO: fuelorder@panta.it FAX For further information please do not hesitate to contact us monico.luca@panta.it Tel saine.baak@panta.it Tel cristofanilli.giovanni@panta.it pag. 2 5

6 2. MICHELIN TYRES ORDER FORM CLOSER TO RALLY. FIA WORLD RALLY CHAMPIONSHIP 2017 SUPPLY CONDITIONS OF TYRES FOR TESTING AND EVENTS FORM A COMPANY DETAILS TO BE SENT TO: Mr. Turuani Fabien ( wrc.order@ceerta.com) Company/Team Name: Driver Name: Address: ZIP CODE: City: Country: VAT identification number: Contact Person: /Fax: TEAM STAMP AND SIGNATURE DATE: 6

7 2. MICHELIN TYRES ORDER FORM CLOSER TO RALLY. FIA WORLD RALLY CHAMPIONSHIP 2017 SUPPLY CONDITIONS OF TIRES FOR TESTING AND FOR EVENTS ( SWEDEN) FORM B ORDER FORM FOR RALLY WRC 1 & 2 DATE: COMPANY/TEAM NAME: CONTACT NAME: ADDRESS / FAX/ TEL NUMBER: Size Tread Type/Rally Left/ Right Unit Price (EUR) Without VAT 15/65-15 X-Ice North 3L Snow/Ice L 460,00 Number of tyres Total amount 15/65-15 X-Ice North 3R Snow/Ice R 460,00 TOTAL ORDER AMOUNT VAT NOT INCLUDED: EUR TOTAL NUMBER OF TIRES: REQUESTED DELIVERY DATE: DELIVERY LOCATION FOR TESTING: TIRE QUANTITY AND DELIVERY DATE SUBJECT TO CEERTA S WRITTEN CONFIRMATION 7

8 3. HELICOPTER REGISTRATION FORM HELICOPTER Helicopter s registration: Make and model: Colours: OWNER Company / Name: Address: Phone: Flight Manager Name: Phone: Invoice/billing address: OPERATION What will be the use of the helicopter during the rally? Flying under contract from: Overnight parking location: Wich dates will you be flying during the rally? FRIDAY 10 FEB SATURDAY 11 FEB SUNDAY 12 FEB PILOT Name: Phone: address (all info will be by ) Address and mobile phone during the event: I, the pilot/commander of the above helicopter, agree to follow the rules notified to me during the Rally. I am personally responsible for attaining this accreditation by attanding the Safety Briefing. SIGNATURE:... Send to the event Helicopter Coordinator Lars Gunnar Gustafsson l.g.gus@telia.com, Mobile: +46 (0) , Fax: +46 (0) Closing date for registration of helicopters is Wednesday 1 February. 8

9 4. DRONE REGISTRATION FORM DRONE Model: OWNER Company / Name: Address: Phone: Manager Name: Phone: Invoice/billing address: OPERATION What will be the use of the drone during the rally? Flying under contract from: Wich dates will you be flying during the rally? OPERATOR Name: Phone: address (all info will be by ) Address and mobile phone during the event: PERMISSIONS (according to Rally Guide 2, art. 9.1) I, the operator of the above drone, agree to follow the rules notified to me during the Rally. SIGNATURE:... Send to the event Helicopter Coordinator Lars Gunnar Gustafsson l.g.gus@telia.com, Mobile: +46 (0) , Fax: +46 (0) Closing date for registration of drones is Wednesday 1 February. 9

10 5. RECCE REGISTRATION FORM Please submit this form to the organiser at the registration for the reconnaissance.. start no: CREW Driver Mobile phone Co-Driver Mobile phone Team contact person during recce Mobile phone RECCE CAR Make & model Registration No Colour ACCOMMODATION DURING RECCE Tuesday 7 Feb Wednesday 8 Feb 10

11 6. ADDITIONAL MATERIALS ORDER FORM Material and documents included in the entry fees are listed in 2017 FIA WRC Regulations Appendix VI and in Art in the Supplementary Regulations. Any other material must be ordered by using this form. The duly completed form much reach the Rally Office at the latest on Tuesday 24. January Order details may also be sent by fax: Materials, both included in the entry fee and additional ordered, may be collected from the Rally HQ during the times scheduled in Art 3. Pay to: Name of the bank: SWEDBANK Address: SE Stockholm, Sweden Bank account: IBAN = SE Swift-id = SWEDSESS In Sweden: Bankgiro: (Swebank) To be able to collect the material you must show the letter with confirmation of entry and the receipt of payment. PRODUCT PRICE / UNIT QUANTITY PRICE TOTAL Auxiliary plate Road Book Official Route Map Team Pass Rally pass (ticket 3-days) Rally Magazine incl. route map SEK 750 SEK 50 SEK 480 SEK 480 SEK 80 SEK VAT is included in the prices total to pay CONTACT DETAILS Team Name/Driver Contact Person Phone Fax Mobile Phone Invoice Address VAT Number a receipt will be sent by mail when payment is received. 11

12 7. SERVICE PARK FACILITIES ORDER FORM ORDER Item Price per unit Amount ordered Total price Private Toilet (inc. emptying service) SEK* Fresh water tank 1000L (with pump) 500 SEK* (1500 SEK*) Waste water tank 1000L Waste water emptying 1000L Additional service space 500 SEK* 500 SEK* 150 SEK* per extra sq.met * excluding VAT (25% in Sweden) Pay to: Name of the bank: SWEDBANK Address: SE Stockholm, Sweden Bank account: IBAN = SE Swift-id = SWEDSESS In Sweden: Bankgiro: (Swebank) CONTACT DETAILS Team Name/Driver Contact Person Phone Fax Mobile Phone Invoice Address VAT Number 12 SEND THE ORDER FORM TO: Rally Sweden, Lantvärnsgatan 4, SE Karlstad Fax number: +46 (0) , mailbox@rallysweden.com THE ORDER FORM MUST REACH THE ORGANISER AT THE LATEST ON 24 JANUARY 2017 a receipt will be sent by mail when payment is received. WIFI You can order WiFi at the service area in Karlstad. (1. February at the latest) Order directly from Event-IP, Matthew Irving, matthewi@event-ip.com ELECTRICITY Electricity should be ordered directly from: TOPLAK See details in Art. 5.7 (22. January at the latest) attn. Gregor Weissegger weissegger@toplak.com Mobile:

13 8. RECCE APPLICATION FOR NON-ENTRANTS RECCE APPLICATION FOR NON-ENTRANTS DRIVER DETAILS CLOSER TO RALLY. APPLICANT If other than member of the crew DRIVER CO-DRIVER Applicant Family Name First Name Nationality (as passport) Street Address Postal Code City Country Address for correspondance (only one) Telephone (day time) Mobile Fax Competition Licence Number Issuing ASN Driving LIcence Number Country of Issue The recce form (page 3) with details of the recce car has to be submitted to the organiser at the registration for recce, in accordance with Art 9.1 of the Supplementary Regulations. This form (page 1 and 2) must be sent to the organiser before January

14 8. RECCE APPLICATION FOR NON-ENTRANTS CLOSER TO RALLY. RECCE APPLICATION FOR NON-ENTRANTS SIGNATURES AND PAYMENT APPLICATION FEE: VAT (6%) Pay to: Name of the bank: SWEDBANK Address: SE Stockholm, Sweden Bank account: IBAN = SE Swift-id = SWEDSESS In Sweden: Bankkonto: Swedbank RELEVANT RESULTS Results Year År Event Tävling Overall Position Total placering Class Position Klassplacering International National Other I hereby declare that I take part in the reconnaissance for Rally Sweden 2017 at my own risk. I will not hold the Organiser, its Officials, the Swedish Autombile Sports Federation or the FIA responsible for any accidents, injuries etc occuring during the recce. I have knowledge of and undertake to follow regulations and rules governing the reconnaissance, as well as instructions and decisions of the organisers. Signatures Date Applicant if other than member of the crew driver Co-driver Please send your application form to: Rally Sweden, Lantvärnsgatan 4, SE Karlstad, Sweden Fax: entry@rallysweden.com This form (page 1 and 2) must be sent to the organiser before January

15 8. RECCE APPLICATION FOR NON-ENTRANTS RECCE REGISTRATION FORM CLOSER TO RALLY. Please submit this form to the organiser at the registration for the reconnaissance. CREW Driver Mobile phone Co-Driver Mobile phone Team contact person during recce Mobile phone RECCE CAR Make & model Registration No Colour ACCOMMODATION DURING RECCE Tuesday 7 Feb Wednesday 8 Feb 15

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