Diesel fuel filter blocking survey

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Where and when your vehicle was refuelled before the breakdown

 

1. When was your breakdown?

   DD/MM/YYYY 
 
 

2. For the car that suffered the breakdown, what is the:

 

3. What is your car's age identifier, given on the registration plate? If registered:
  • after September 2001 this is the 2 numbers such as the "12" in AB12CDE  
  • before September 2001 this is the first letter such the "A" in A123DEF

 

4. For the car that suffered the breakdown, what was the mileage at the time?

 

5. Can you tell us either where or when the vehicle last refuelled before the breakdown? *