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Owner / Vehicle Registered Owner Form

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Full Registered Owner Name: *

Home Address: *

Phone Number: *

E-mail address: *

Owners Drivers License Number & State *

Vehicle Year & Make *

Vehicle Model & Trim *

Vehicle Color *

Vehicle VIN *

Vehicle License Plate Number & State *

Email Photo Of Drivers License to service@rasths.net

Email Photo Of Vehicle Title to service@rasths.net

Email Photo of Vehicle Registration to service@rasths.net

Vehicle Location Address: *

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I hereby agree that my data entered in the contact form will be stored electronically, and will be processed and used for the purpose of establishing contact. I do hereby state and confirm that i am the legal owner of the vehicle and it is registered to myself. I do hereby affirm that all information on this form is true and valid. Upfront Fees Key-Code $95.00 not refundable not guarantied. I do understand that the upfront fees are non-refundable. the key-code(s) for your vehicle are obtained thru a 3ard party and are not guaranteed to work your vehicle. the key-code was originally recorded by the manufacture and from the original locks on the vehicle. Occasionally the manufacture does record them wrong.

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