I am aware that the Subject Vehicle is subject to an important safety recall notice issued by American
Honda Motor Co., Inc. (“Honda”).
I am aware that Honda has decided that a defect which relates to motor vehicle safety may exist in the
Subject Vehicle. In some vehicles, the driver's or passenger's front airbag inflator could produce
excessive internal pressure upon deployment. If an affected airbag deploys, the increased internal
pressure may cause the inflator to rupture and deploy abnormally. In the event of an inflator rupture,
metal fragments could pass through the airbag cushion material possibly causing serious injury or fatality
to vehicle occupants.
I understand that the Subject Vehicle’s driver's and/or passenger's front airbag inflator is required to be
replaced under the recall described above ("Subject Recall Repair”). I also understand that the
replacement airbag inflator needed to make the Subject Recall Repair is not available at this time. I have
therefore elected to drive a loaner car provided through an authorized Honda dealership
(“Dealership”) until the Subject Recall Repair(s) can be completed.
I also understand that Honda’s policy is that the Dealership retain the Subject Vehicle at the
Dealership until the parts necessary to complete the Subject Recall Repair are available.
I wish to retain the Subject Vehicle in my possession until the parts necessary to complete the Subject
Recall Repair become available. I understand this deviates from Honda's requirement that the
Dealership retain the Subject Vehicle. In order to obtain the consent of Honda and the Dealership to my
retention of the Subject Vehicle until the parts become available for the Subject Recall Repair(s), I
specifically and knowingly make the following agreements:
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 I agree to not drive the Subject Vehicle while it is in my possession, custody, or control until the
Subject Recall Repair is completed other than directly to or from the Dealership.
 I agree to not allow the Subject Vehicle to be driven by others, and will ensure that all keys/key
fobs to the vehicle are inaccessible to all others, until the Subject Recall Repair is completed.
 I agree either to drive the Subject Vehicle directly to its place of storage or to allow the Dealership
to tow the Subject Vehicle from the Dealership to my home, at no cost to me.
 I agree either to drive the Subject Vehicle directly to the Dealership or to allow the Dealership to
tow the Subject Vehicle to the Dealership after the Dealership notifies me that the parts
necessary to complete the Subject Recall Repair have become available, at no cost to me.
 I agree to maintain possession of the Subject Vehicle and will not sell, alter, or modify the Subject
Vehicle until such time as the Subject Recall Repair is performed.
 Should I lose possession of the Subject Vehicle before the Subject Recall Repair is performed, I
agree to notify the Dealership immediately, and no later than 24 hours after I have lost
possession of the Subject Vehicle.
 I agree that I will be responsible if I cause the Subject Vehicle to be driven other than directly to or
from the Dealership prior to the performance of the Subject Recall Repair.