RALLY GUIDE 2 2017 › wp-content › uploads › 2016 › 11 › rally...recce, in accordance with Art 9.1 of the Supplementary Regulations. This form (page 1 and 2) must be sent

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RALLY GUIDE 22017APPENDIX 5FORMS

09-12 FEBRUARY 2017RALLYSWEDEN.COM#RALLYSWEDEN

RALLY GUIDE 2 - APPENDIX 5 FORMS

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APPENDIX 5 - FORMS

1. EVENT FUEL PURCHASE ORDER FORM ................................................................... 4

2. MICHELIN TYRES ORDER FORM ............................................................................................... 6

3. HELICOPTER REGISTRATION FORM .......................................................................... 8

4. DRONE REGISTRATION FORM ........................................................................................................ 9

5. RECCE REGISTRATION FORM ................................................................................ 10

6. ADDITIONAL MATERIALS ORDER FORM ................................................................... 11

7. SERVICE PARK FACILITIES ORDER FORM .................................................................. 12

8. RECCE APLICATION FOR NON-ENTRANTS ............................................................ 13


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1. EVENT FUEL PURCHASE ORDER FORM

pag. 1

FUEL ORDER FORM WRC 2017

RACE:_____________________________

TEAM:_____________________________

DRIVER AND NUMBER PANTA MAX WRC RON 102

25 LT DRUMS (SHAKE DOWN) FUEL DISPENSED

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 STREET CITY POST CODE

CONTACTS PHONE

FAX MOBILE

CONTACT PERSON

NAME E.MAIL


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pag. 2

PAYMENT

Bank transfer ( please attach a copy) Credit Card (only VISA or MASTERCARD)

Account Owner: PANTA DISTRIBUZIONE S.p.A.

Bank:

BANCA POPOLARE DI SONDRIO

IBAN Code: IT58U0569620300000002103X34

BIC=SWIFT CODE: POSOIT22

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: [email protected]

FAX 0039 0373 235123

For further information please do not hesitate to contact us [email protected] Tel. 0039 0373 235141 [email protected] Tel. 0039 0373 235142

[email protected]


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2. MICHELIN TYRES ORDER FORM

17 Boulevard D’Italie – 98000 Monaco Tél : (+33) 06 42 57 64 26 Site : www.rallysportmanagement.com E.mail : [email protected] SARL RALLY SPORT MANAGEMENT – RCI 12S05693 – N° TVA Intra com . FR 70 000 095 629

FIAWORLDRALLYCHAMPIONSHIP2017

SUPPLYCONDITIONSOFTYRESFORTESTINGANDEVENTS

FORMA

COMPANYDETAILS

TOBESENTTO:Mr.TuruaniFabien(email:[email protected])

Company/TeamName:___________________________________

DriverName:_____________________________________________

Address:________________________________________________

ZIPCODE:________

City:_____________________

Country:___________________

VATidentificationnumber:________________________

ContactPerson:_________________________________

E-mail/Fax:___________________________________

TEAMSTAMPANDSIGNATUREDATE:_____________


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2. MICHELIN TYRES ORDER FORM

Z.I. de Lavaur – 63500 Issoire – France Tél : (+33) 04 73 55 56 56 Site : www.ceerta.com Fax : (+33) 04 73 55 56 59 e.mail : wrc.orderceerta.com S.A.S. au capital de 91 469,41€ - siret 404 533 937 000 11 – RCS de Clermont-Ferrand : B 404 533 937 – N° TVA Intra com . FR 00 404 533 937

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: ____________________________________________ EMAIL ADDRESS / FAX/ TEL NUMBER: ____________________________

Size Tread Type/Rally Left/Right

Unit Price (EUR)

Without VAT

Number of tyres Total amount

15/65-15 X-Ice North 3L Snow/Ice L 460,00€

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


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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?

PILOT

Name:

Phone:

E-mail address (all info will be by e-mail)

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 e-mail: [email protected], Mobile: +46 (0)70 648 50 78, Fax: +46 (0)54 18 05 30

Closing date for registration of helicopters is Wednesday 1 February.

FRIDAY 10 FEB SATURDAY 11 FEB SUNDAY 12 FEB


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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:

E-mail address (all info will be by e-mail)

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 e-mail: [email protected], Mobile: +46 (0)70 648 50 78, Fax: +46 (0)54 18 05 30

Closing date for registration of drones is Wednesday 1 February.

4. DRONE REGISTRATION FORM


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5. RECCE REGISTRATION FORM

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

start no:


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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 4.4.2 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 2017e-mail: [email protected] Order details may also be sent by fax: +46 54 18 05 30

Materials, both included in the entry fee and additional ordered, may be collected from the Rally HQ during thetimes scheduled in Art 3.

Pay to: Name of the bank: SWEDBANK Address: SE-105 34 Stockholm, Sweden Bank account: IBAN = SE43 8000 0815 6203 3000 8921 Swift-id = SWEDSESSIn Sweden: Bankgiro: 5674-2836 (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 2 500 SEK

Road Book 750 SEK

Official Route Map 50 SEK

Team Pass 480 SEK

Rally pass (ticket 3-days) 480 SEK

Rally Magazine incl. route map 80 SEK

VAT is included in the prices TOTAL TO PAY

CONTACT DETAILS

Team Name/Driver

Contact Person

Phone

Fax

E-mail

Mobile Phone

Invoice Address

VAT Number

A receipt will be sent by mail when payment is received.


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7. SERVICE PARK FACILITIES ORDER FORM

ORDER

Item Price per unit Amount ordered Total price

Private Toilet (inc. emptying service) 5 000 SEK*

Fresh water tank 1000L (with pump) 500 SEK* (1500 SEK*)

Waste water tank 1000L 500 SEK*

Waste water emptying 1000L 500 SEK*

Additional service space150 SEK* per extra

sq.met

* excluding VAT (25% in Sweden)Pay to: Name of the bank: SWEDBANK Address: SE-105 34 Stockholm, Sweden Bank account: IBAN = SE43 8000 0815 6203 3000 8921 Swift-id = SWEDSESSIn Sweden: Bankgiro: 5674-2836 (Swebank)

CONTACT DETAILS

Team Name/Driver

Contact Person

Phone

Fax

E-mail

Mobile Phone

Invoice Address

VAT Number

SEND THE ORDER FORM TO:

Rally Sweden, Lantvärnsgatan 4, SE-652 21 KarlstadFax number: +46 (0)54 18 05 30, E-mail: [email protected]

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, e-mail: [email protected]

ELECTRICITY

Electricity should be ordered directly from: TOPLAK See details in Art. 5.7 (22. January at the latest) attn. Gregor Weissegger E-mail: [email protected] Mobile: +43 676 838 99238


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8. RECCE APPLICATION FOR NON-ENTRANTS

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RECCE APPLICATION FORM NON-ENTRANTS 2017 1

RECCE APPLICATION FOR NON-ENTRANTS DRIVER DETAILS

APPLICANTIf other than

member of the crewDRIVER 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

E-mail

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 25.


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8. RECCE APPLICATION FOR NON-ENTRANTSCLOSER TO RALLY.

RECCE APPLICATION FORM NON-ENTRANTS 20172

RECCE APPLICATION FOR NON-ENTRANTS SIGNATURES AND PAYMENT

APPLICATION FEE: 1 200 € + VAT (6%)

ResultsYear

ÅrEvent

TävlingOverall Position

Total placeringClass PositionKlassplacering

International

National

Other

Pay to: Name of the bank: SWEDBANK Address: SE-105 34 Stockholm, Sweden Bank account: IBAN = SE43 8000 0815 6203 3000 8921 Swift-id = SWEDSESS

In Sweden: Bankkonto: Swedbank 8156-3 330000892-1

RELEVANT RESULTS

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-651 13 Karlstad, Sweden Fax: +46 54 18 05 30 E-mail: [email protected]

This form (page 1 and 2) must be sent to the organiser before January 25.


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8. RECCE APPLICATION FOR NON-ENTRANTS

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RECCE APPLICATION FORM NON-ENTRANTS 2017 3

RECCE REGISTRATION FORM

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

Documents

RALLY GUIDE 2 2017 › wp-content › uploads › 2016 › 11 › rally...recce, in accordance with Art 9.1 of the Supplementary Regulations. This form (page 1 and 2) must be sent