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Title*

Name (or Company Name)*

Street Address*

Suburb/Town*

State/Territory*

Postcode*

Phone*

Email*

Toyota Model*

Further Model Details (if known)

Year of manufacture*

Date of acquisition*

DD slash MM slash YYYY

For this Class Action, the vehicle must have been acquired between 7 February 2016 and 19 December 2024.

Was the vehicle acquired new or second hand?*

New

Second hand

Was the vehicle owned, leased or a hire purchase?*

Owned

Leased

Hire purchase

Do you still have this vehicle?*

Yes

No

Registration number*

VIN number

Please provide the VIN number if possible

Where did you acquire the vehicle?*

From an authorised Toyota dealer

From a non-Toyota dealer

Privately

Other

Name of Vehicle Vendor

Purchase price of vehicle?*

Approximate number of kilometres on odometer at time of purchase?*

Approximate number of kilometres on odometer on vehicle currently?*

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