REQUEST FOR REIMBURSEMENT FORM: WTY004 - IF YOU HAVE PAID TO HAVE YOUR ENGINE REPAIRED/REPLACED DUE TO CONNECTING ROD FAILURE, YOU MAY BE ELIGIBLE FOR REIMBURSEMENT FOR SOME OR ALL OF THAT EXPENSE. MAIL THIS COMPLETED REQUEST FOR REIMBURSEMENT FORM TO KIA, ALONG WITH DOCUMENTATION SPECIFIED BELOW, FOR REVIEW AND CONSIDERATION TO THE FOLLOWING ADDRESS: CONSUMER ASSISTANCE CENTER, KIA MOTORS AMERICA, INC., P.O. BOX 52410, IRVINE, CA 92619-2410, 1-800-333-4542
