"Record of Transaction | |
# | ________________________________ |
(Transaction number printed on the form) | |
(1) Description of Property | ________________________________ |
_________________________________________________________________ | |
_________________________________________________________________ | |
_________________________________________________________________ | |
_________________________________________________________________ | |
(2) _______________________________ | (3) __________________________ |
(Vehicle Identification Number) | (State of Origin) |
(4) ______________, ___ | (5) __________________________ |
(Date) | (Name of Dealer/Employee) |
(6) ______________________, | ___________________, ___ |
(Name of Customer) | (Date of Birth) |
__________________________, | ___________________________ |
(Driver's License No./ Mich. Personal ID Number) | (Street Address) |
___________________________ | |
(City & State) | (Zip) |
(7) ______________________ | |
(Price Paid) | |
(8) ______________________ | |
(Check no., bank draft | |
no., money order no., | |
transaction no., or cash) | |
____________________________" | |
Thumbprint | (Signature of Customer) |
MCL 257.1352