2019 RALLY GUIDE 2 - FORMS - Rally Sweden
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CLOSER TO RALLY.
RALLY
GUIDE 2
2019
APPENDIX 5
FORMS
14-17 FEBRUARY 2019
RALLYSWEDEN.COM
#RALLYSWEDEN
CLOSER TO RALLY. 2 RALLY GUIDE 2 - APPENDIX 5 FORMS
CLOSER TO RALLY.
APPENDIX 5 - FORMS
1. RECCE REGISTRATION FORM ............................................................................................ 4
2. ADDITIONAL MATERIALS ORDER FORM ................................................................... 5
3. SERVICE PARK FACILITIES ORDER FORM .................................................................. 6
4. EVENT FUEL PURCHASE ORDER FORM ................................................................... 7
5. TECHNICAL DATA SHEET FUEL................................................................................................ 11
6. MICHELIN TYRES ORDER FORM ............................................................................................... 12
7. PIRELLI TYRES ORDER FORM ...........................................................................................................15
8. HELICOPTER REGISTRATION FORM .......................................................................... 16
9. DRONE REGISTRATION FORM ........................................................................................................ 17
10. RECCE APPLICATION FOR NON-ENTRANTS ............................................................ 18
RALLY GUIDE 2 - APPENDIX 5 FORMS 3
CLOSER TO RALLY.
1. RECCE REGISTRATION FORM
Please submit this form to the organiser at the registration for the reconnaissance..
start no:
CREW
Driver
Mobile phone
Co-Driver
Mobile phone
Team contact person during recce
Mobile phone
RECCE CAR
Make & model
Registration No
Colour
ACCOMMODATION DURING RECCE
Tuesday 12 Feb – Wednesday 13
Feb
4 RALLY GUIDE 2 - APPENDIX 5 FORMS
CLOSER TO RALLY.
2. ADDITIONAL MATERIALS ORDER FORM
Material and documents included in the entry fees are listed in 2019 FIA WRC Regulations Appendix VI and in Art
4.4.2 in the Supplementary Regulations.
Any other material must be ordered by using this form.
The duly completed form much reach the Rally Office at the latest on Wednesday 30. January 2019
e-mail: entry@rallysweden.com
Order details may also be sent by fax: +46 54 18 05 30
Materials, both included in the entry fee and additional ordered, may be collected from the Rally HQ during the
times scheduled in Art 3.
Pay to: Name of the bank: SWEDBANK
Address: SE-105 34 Stockholm, Sweden
Bank account: IBAN = SE85 80000 8156 29 03 0406 772
Swift-id = SWEDSESS
In Sweden: Bankgiro: 5070-5169 (Swebank)
To be able to collect the material you must show the letter with confirmation of entry and the receipt of payment.
PRODUCT PRICE / UNIT QUANTITY PRICE TOTAL
Auxiliary plate 2 500 SEK
Road Book 750 SEK
Official Route Map 50 SEK
Team Pass 600 SEK
Festival pass (ticket 3-days) 600 SEK
Rally Magazine incl. route map 100 SEK
VAT is included in the prices TOTAL TO PAY
CONTACT DETAILS
Team Name/Driver
Contact Person
Phone
Fax
E-mail
Mobile Phone
Invoice Address
VAT Number
A receipt will be sent by mail when payment is received.
RALLY GUIDE 2 - APPENDIX 5 FORMS 5
CLOSER TO RALLY.
3. SERVICE PARK FACILITIES ORDER FORM
ORDER
Item Price per unit Amount ordered Total price
Private Toilet (inc. emptying service) 5 000 SEK*
Fresh water tank 1000L (with pump) 500 SEK* (1500 SEK*)
Waste water tank 1000L 500 SEK*
Waste water emptying 1000L 500 SEK*
150 SEK* per extra
Additional service space
sq.met
* excluding VAT (25% in Sweden)
ay to: Name of the bank: SWEDBANK
Address: SE-105 34 Stockholm, Sweden
Bank account: IBAN = SE85 80000 8156 29 03 0406 772
Swift-id = SWEDSESS
In Sweden: Bankgiro: 5070-5169 (Swebank)
CONTACT DETAILS
Team Name/Driver
Contact Person
Phone
Fax
E-mail
Mobile Phone
Invoice Address
VAT Number
SEND THE ORDER FORM TO:
Rally Sweden, Lantvärnsgatan 4, SE-652 21 Karlstad
Fax number: +46 (0)54 18 05 30, E-mail: mailbox@rallysweden.com
THE ORDER FORM MUST REACH THE ORGANISER AT THE LATEST ON 30 JANUARY 2019
A receipt will be sent by mail when payment is received.
___________________________________________________________________________________________________________________________________________
WIFI
You can order WiFi at the service area in Karlstad. (30. January at the latest)
Order directly from Event-IP, Matthew Irving, e-mail: matthewi@event-ip.com
ELECTRICITY
Electricity should be ordered directly from: TOPLAK
See details in Art. 5.7 (26. January at the latest) attn. Gregor Weissegger
E-mail: weissegger@toplak.com
Mobile: +43 676 838 99238
6 RALLY GUIDE 2 - APPENDIX 5 FORMS
CLOSER TO RALLY. 4. EVENT FUEL PURCHASE ORDER PROCEDURE RALLY GUIDE 2 - APPENDIX 5 FORMS 7
CLOSER TO RALLY.
4. EVENT FUEL PURCHASE ORDER PROCEDURE
8 RALLY GUIDE 2 - APPENDIX 5 FORMSCLOSER TO RALLY.
4. EVENT FUEL PURCHASE ORDER PROCEDURE
RALLY GUIDE 2 - APPENDIX 5 FORMS 9CLOSER TO RALLY.
4. EVENT FUEL PURCHASE ORDER PROCEDURE
10 RALLY GUIDE 2 - APPENDIX 5 FORMSCLOSER TO RALLY.
5. TECHNICAL DATA SHEET FUEL
TOTAL ADDITIFS ET CARBURANTS SPECIAUX
Place du bassin - 69700 Givors - France
Tel +33 4 72 49 84 10 - Fax +33 4 72 49 84 20
TOTAL Excellium Rally
(Official FIA WRC fuel 2019-2020-2021)
Certificate of Analysis - Batch. PCH110174G
Date : 20/11/2018
FIA Appendix J
PROPERTIES UNITS TEST METHODS RESULTS
SPECIFICATIONS
Density at 15°C kg/m3 EN ISO 12185 745,6 720,0 - 785,0
DVPE kPa EN 13016-1 56 < 80
Distillation EN ISO 3405
E70 °C %v/v 42,1 20,0 - 52,0
E100 °C %v/v 71,0 46,0 - 72,0
E150 °C %v/v > 95,0 > 75,0
FBP °C 123 < 210
Residue %v/v 0,9 < 2,0
RON EN ISO 5164 101,7 95,0 - 102,0
MON EN ISO 5163 88,4 85,0 - 90,0
Aromatics content %v/v EN ISO 22854 < 35,0 < 35,0
Olefins content %v/v EN ISO 22854 < 18,0 < 18,0
Total di-olefins content %m/m < 1,0 < 1,0
Benzene content %v/v EN ISO 22854 < 1,0 < 1,0
Oxygen content %m/m EN ISO 22854 3,5 < 3,7
Lead content mg/L EN 237 360
RALLY GUIDE 2 - APPENDIX 5 FORMS 11CLOSER TO RALLY.
6. MICHELIN TYRES ORDER FORM
FIA WORLD RALLY CHAMPIONSHIP 2017
SUPPLY CONDITIONS OF TYRES FOR TESTING AND EVENTS
FORM A
COMPANY DETAILS
TO BE SENT TO: Mr. Turuani Fabien (email: wrc.order@ceerta.com)
Company/Team Name: ___________________________________
Driver Name: _____________________________________________
Address: ________________________________________________
ZIP CODE: ________
City: _____________________
Country: ___________________
VAT identification number: ________________________
Contact Person: _________________________________
E-mail /Fax: ___________________________________
TEAM STAMP AND SIGNATURE DATE: _____________
12 17 Boulevard D’Italie – 98000 Monaco RALLY GUIDE 2 - APPENDIX 5 FORMS
Tél : (+33) 06 42 57 64 26 Site : www.rallysportmanagement.com
E.mail : wrc.order@ceerta.comCLOSER TO RALLY.
6. MICHELIN TYRES ORDER FORM
FIA WORLD RALLY CHAMPIONSHIP 2019
SUPPLY CONDITIONS OF TIRES FOR TESTING AND FOR EVENTS
( SWEDEN)
FORM B
ORDER FORM FOR RALLY WRC 1 & 2
DATE: _____________
COMPANY/TEAM NAME: ______________________________________
CONTACT NAME: ____________________________________________
EMAIL ADDRESS / FAX/ TEL NUMBER: ____________________________
Unit Price
Left/ (EUR) Number
Size Tread Type/Rally Total amount
Right Without of tyres
VAT
15/65-15 X-Ice North 3L Snow/Ice L 460,00€
15/65-15 X-Ice North 3R Snow/Ice R 460,00€
TOTAL ORDER AMOUNT VAT NOT INCLUDED: EUR ___________________
TOTAL NUMBER OF TIRES: _____________
REQUESTED DELIVERY DATE: ________________________
DELIVERY LOCATION FOR TESTING: _____________________________
TIRE QUANTITY AND DELIVERY DATE SUBJECT TO CEERTA’S WRITTEN CONFIRMATION
Z.I. de Lavaur – 63500 Issoire – France
Tél : (+33) 04 73 55 56 56 Site : www.ceerta.com
RALLY GUIDE 2 - APPENDIX
Fax : (+33) 04 73 55 56 59 5 FORMS
e.mail : wrc.orderceerta.com 13
S.A.S. au capital de 91 469,41€ - siret 404 533 937 000 11 – RCS de Clermont-Ferrand : B 404 533 937 – N° TVA Intra com .CLOSER TO RALLY.
6. MICHELIN TYRES ORDER FORM WRC2 CARS
FIA WORLD RALLY CHAMPIONSHIP 2019
SUPPLY CONDITIONS OF TIRES FOR TESTING AND FOR EVENTS
( SWEDEN)
FORM B
ORDER FORM FOR RALLY WRC2
DATE: _____________
COMPANY/TEAM NAME: ______________________________________
CONTACT NAME: ____________________________________________
EMAIL ADDRESS / FAX/ TEL NUMBER: ____________________________
Unit Price
Left/ (EUR) Number
Size Tread Type/Rally Total amount
Right Without of tyres
VAT
X-Ice North
15/65-15 Snow/Ice L 460,00€
NA01L
X-Ice North
15/65-15 Snow/Ice R 460,00€
NA01R
TOTAL ORDER AMOUNT VAT NOT INCLUDED: EUR ___________________
TOTAL NUMBER OF TIRES: _____________
REQUESTED DELIVERY DATE: ________________________
DELIVERY LOCATION FOR TESTING: _____________________________
TIRE QUANTITY AND DELIVERY DATE SUBJECT TO CEERTA’S WRITTEN CONFIRMATION
Z.I. de Lavaur – 63500 Issoire – France
Tél : (+33) 04 73 55 56 56 Site : www.ceerta.com
Fax : (+33) 04 73 55 56 59 e.mail : wrc.orderceerta.com
S.A.S. au capital de 91 469,41€ - siret 404 533 937 000 11 – RCS de Clermont-Ferrand : B 404 533 937 – N° TVA Intra com .
FR 00 404 533 937
14 RALLY GUIDE 2 - APPENDIX 5 FORMSCLOSER TO RALLY.
7. PIRELLI TYRES ORDER FORM
Event:
Rally Sweden WRC 2019
Customer's Details:
Name:
Company:
Street/House Number:
ZIP Code:
City:
Country:
VAT:
Phone Number:
Email address:
Tire Order:
Type Size Type Stud Net Price Order Qty Total Price
205/65R15 RFID Left 7mm 404,00 €
ICE
J1A Right 7mm 404,00 €
Total 0,00 €
Dealer's Contact:
Name: Anders Åberg
Company: PSport.se / A. Åbergs Bil & Import AB
Street/House Number: Herkulesvägen 2
ZIP Code: 28143
City: Hässleholm
Country: Sweden
VAT: SE556868547201
Phone Number: +46 (0) 709-10 15 50
Email address: info@psport.se
Payment term:
BANK TRANSFER CREDIT CARD
IBAN Card Number
BIC Owner
SWIFT Exp Date
Name Security code
Above tire list is valid for WRC2 and priority drivers nominated by FIA as per WRC Art. 60.3
RALLY GUIDE 2 - APPENDIX 5 FORMS 15CLOSER TO RALLY.
8. HELICOPTER REGISTRATION FORM
CLOSER TO RALLY.
HELICOPTER REGISTRATION FORM
HELICOPTER
Helicopter’s registration:
Make and model:
Colours:
OWNER
Company / Name:
Address:
Phone:
Flight Manager Name:
Phone:
Invoice/billing address:
OPERATION
What will be the use of the
helicopter during the rally?
Flying under contract from:
Overnight parking location:
Wich dates will you be flying FRIDAY SATURDAY SUNDAY
during the rally? 190215 190216 190217
PILOT
Name:
Phone:
E-mail address
(all info will be by e-mail)
Address and mobile
phone during the event:
I, the pilot/commander of the above helicopter, agree to follow the rules notified to me during
the Rally.
I am personally responsible for attaining this accreditation by attanding the Safety Briefing.
SIGNATURE: ................................................................................................................................................................................................................
Send to the event Helicopter Coordinator Lars Gunnar Gustafsson
e-mail: l.g.gus@telia.com, mailbox@rallysweden.com, Mobile: +46 (0)70 648 50 78
Closing date for registration of helicopters is Friday 8 February.
16 RALLY GUIDE 2 - APPENDIX 5 FORMSCLOSER TO RALLY.
9. DRONE REGISTRATION FORM
CLOSER TO RALLY.
DRONE REGISTRATION FORM
DRONE
Model: Weight:
OWNER
Company / Name:
Address:
Phone:
Manager Name:
Phone:
Invoice/billing address:
OPERATION
What will be the use of the drone
during the rally?
Flying under contract from:
Wich dates will you be flying FRIDAY SATURDAY SUNDAY
during the rally? 190215 190216 190217
OPERATOR
Name:
Phone:
E-mail address
(all info will be by e-mail)
Address and mobile
phone during the event:
PERMISSIONS (according to Rally Guide 2, art. 9.1)
I, the operator of the above drone, agree to follow the rules notified to me during the Rally.
SIGNATURE: ................................................................................................................................................................................................................
Send to the event Helicopter Coordinator Lars Gunnar Gustafsson
e-mail: l.g.gus@telia.com, mailbox@rallysweden.com, Mobile: +46 (0)70 648 50 78
Closing date for registration of drones is Friday 8 February.
RALLY GUIDE 2 - APPENDIX 5 FORMS 17CLOSER TO RALLY.
10. RECCE APPLICATION FOR NON-ENTRANTS
CLOSER TO RALLY.
RECCE APPLICATION FOR NON-ENTRANTS
DRIVER DETAILS
APPLICANT
If other than DRIVER CO-DRIVER
member of the crew
Applicant
Family Name
First Name
Nationality (as passport)
Street Address
Postal Code
City
Country
Address for correspondance
(only one)
Telephone (day time)
Mobile
Fax
E-mail
Competition Licence Number
Issuing ASN
Driving LIcence Number
Country of Issue
The recce form (page 3) with details of the recce car has to be submitted to the organiser at the registration for
recce, in accordance with Art 9.1 of the Supplementary Regulations.
This form (page 1 and 2) must be sent to the organiser before January 30.
18RECCE APPLICATION FORM NON-ENTRANTS 2019 1
RALLY GUIDE 2 - APPENDIX 5 FORMSCLOSER TO RALLY.
10. RECCE APPLICATION FOR NON-ENTRANTS
CLOSER TO RALLY.
RECCE APPLICATION FOR NON-ENTRANTS
SIGNATURES AND PAYMENT
APPLICATION FEE: 1 200 € + VAT (6%)
Pay to: IBAN: SE85 80000 8156 29 03 0406 772
SWIFT: SWEDSESS
Account holder: Rally Sweden AB
Address to the bank: SWEDBANK, SE-105 34 Stockholm, Sweden
Note!: Please mark the payment with the drivers last name.
In Sweden: Bankgiro: 5070-5169
RELEVANT RESULTS
Year Event Overall Position Class Position
Results År Tävling Total placering Klassplacering
International
National
Other
I hereby declare that I take part in the reconnaissance for Rally Sweden 2019 at my own risk. I will not hold the Organiser, its Officials, the
Swedish Autombile Sports Federation or the FIA responsible for any accidents, injuries etc occuring during the recce. I have knowledge of
and undertake to follow regulations and rules governing the reconnaissance , as well as instructions and decisions of the organisers.
Signatures Date ____________________________
_______________________________________ ________________________________________ _____________________________________
Applicant if other than member of the crew driver Co-driver
Please send your application form to: Rally Sweden AB, Lantvärnsgatan 4, SE-651 13 Karlstad, Sweden
Fax: +46 54 18 05 30
E-mail: entry@rallysweden.com
This form (page 1 and 2) must be sent to the organiser before January 30.
RALLY
2 GUIDE 2 - APPENDIX 5 FORMS RECCE APPLICATION FORM NON-ENTRANTS 201919CLOSER TO
CLOSER TO RALLY.
RALLY.
RECCE REGISTRATION FORM
10. RECCE APPLICATION FOR NON-ENTRANTS
Please submit this form to the organiser at the registration for the reconnaissance.
CREW
Driver
Mobile phone
Co-Driver
Mobile phone
Team contact person during recce
Mobile phone
RECCE CAR
Make & model
Registration No
Colour
ACCOMMODATION DURING RECCE
Tuesday 12 Feb –
Wednesday 13 Feb
RECCE APPLICATION FORM NON-ENTRANTS 2019 3
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