Customer declaration, reduction of seat belt warning tone, certification

OF91.60-S-1000-17A

Customer declaration, reduction of seat belt warning tone, certification

MODEL

639

with CODE XZ1 (Model generation 1)

MODEL

906

Modification notes

13.2.15

Model 906 added and content updated

Customer data
Name, address:

Mercedes­Benz Partner data
Name, dealer number:

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Contact:

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Telephone:

Official Registration number:

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E-mail:

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In response to a clearly-stated customer request your vehicle with vehicle identification number

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shall have the seat belt warning tone reduced. As a result of this measure, no acoustic belt reminder will be output for the driver or front passenger while driving. There is therefore a risk of the driver/front passenger forgetting to wear their seat belt.

Risk of injury!
A seat belt which is not worn or not worn correctly cannot perform its protection function. The airbags too can only provide the specified protection, when the occupants are wearing their seat belts correctly. For this reason make sure that all occupants - in particular pregnant women - always wear their seat belts correctly.
The customer is expressly informed of this increased risk of injury should a seat belt not be worn or be worn incorrectly and, furthermore, is bound to notify third parties of the situation before allowing them to use the vehicle.

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(Copy sheet, cut off here and stick the upper section into the operator's manual at the start of the chapter on SAFETY)

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Certificate of compliance, exemption and measures

1.

The customer declared that he is aware of all the hazards and injury risks involved in connection with his requested change, as mentioned above. The customer's signature indicates that the customer expressly approved of such a change.

2.

The customer is aware that on account of his requested change and - as a consequence - his expressly declared approval of the attendant, increased hazards and risks of injury, no claims can be expressed against Daimler AG, its group member companies or its sales partners, which arise – directly or indirectly – because of the above-mentioned change and the related increased risks of injury.

3.

The customer hereby releases Daimler AG from all third-party claims and indemnification as stated under 2.

Vehicle identification number:

Name and address of customer:

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4.

Furthermore, the customer hereby undertakes:

a)

To ensure that

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The above-separated specification is always included with the operator's manual;

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Other users of the vehicle are informed thereof;

b)

Other users/purchasers of the vehicle shall be notified in full of the change and the related hazards and risks of injury involved, and that this be documented;

c)

to have the seat belt warning tone reduction reversed in the event of any change of ownership of the vehicle in a qualified workshop and at their own expense.

Place / date

Date/stamp and signature of Mercedes­Benz Service Support Point

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Signature/Customer

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Process customer request - standard

Reduction in seat belt warning tone

Customer: Inquiry

Via sales to workshop or directly to workshop

Workshop:

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Information, individual case statement.

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Instruction to customer about the stated hazards associated with the pertinent version of the "Seat belt warning tone reduction"customer statement.

Customer and workshop:

1.

Fill out "Seat belt warning tone reduction" customer statement and then copy it:

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Customer signature, workshop stamp and signature.

2.

Customer identification:

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Suitable documentation, e.g. identification-card number.

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Copy of motor vehicle registration certificate.

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Copy of documentation based on the request (e.g. depending on legal situation, medical certificate with regard to exemption to requirement to wear seat belt, documentation of use in distribution haulage, or similar).

Workshop:

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Scan filled out customer statement (see 1.) and customer identification (see 2.) and send per XSF "Xentry Support & Feedback" ticket as an attachment to the Market Performance Center (MPC) or general distributor.

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Trigger parts order (part number see SI00.00-S-0015A)

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SCN coding of instrument cluster following successful feedback per XSF "Xentry Support & Feedback" ticket from GLC Germersheim

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Archiving of copied customer statement (see 1.)

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Separation and sticking of upper section of copied customer statement into operator's manual (At start of Safety chapter).

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Entry into service booklet.

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