Crash Data Form

Please complete the Crash Data Reset form below; submit your details, then print your Crash Data Reset form and send it along with your Airbag ECU to:

Electrotech,
5300 Lakeside
Cheadle Royal Business Park
Cheadle
SK8 3GP

Crash Data Reset Form

Name:
Address Line 1:
Make and Model:
Address Line 2:
Year of manufacture:

County:
Landline Telephone:
Postcode:
Mobile Telephone:
Email:
Airbag ECU Manufacturer
Airbag ECU number
Any Extra Comments
Chosen method of payment: *

  • BACS Transfer
  • Payment over Telephone
  • Cheque with parcel made payable to “Electrotech”

payment will not be required until repair is complete and ready for dispatch.