| Year |
|
| Make |
|
| Model |
|
| VIN# * |
First Digit
Second Digit
Third and Fourth Digits
Fifth Digit
Sixth Digit
Seventh Digit
Remaining Digits
|
| Fender Tag Data * |
SO
Number
BDY
TRM
PAI
N (if no digit under N, enter None)
T
|
Fender Tag Codes - Uppercase Alpahbet Row *
Example: A2,F1,T8
|
|
Fender Tag Codes - Lowercase Alphabet Row *
(If you don't have any enter the word none.)
|
|
| Accessory Group if known * |
Formula S
Sports Package
Suspension Package
None/Not sure
|
| Engine * |
225 cid Slant 6
273 cid V8
|
| Transmission * |
Automatic
3 speed manual
4 speed manual |
| Shifter * |
Column
Floor/ console |
| Axle * |
SureGrip
Standard
Not Sure |
| Which Trim is on your car? *
|
Valiant V 
Barracuda Fish  |
| Which Security Panel is in your car? *
|
Extension 
Short with indent 
Short plain 
Short with stands 
|
Option/Sales Codes (optional)
(If known, found on Broadcast Sheet) Example: Engine: 21, Trans: 5, etc
|
|
Un-documented Factory or Dealer installed options (optional)
(items not verified on the fender tag or broadcast sheet but you know are original to the car.)
|
|
Additional Vehicle Information (optional)
(engine swaps, brake upgrades, comments, remarks, etc) : |
|
| Current Owner (optional) |
|
| Email Address: (optional) |
|
| Location of car (Country, State or Provence) * |
|
| Status * |
On the road/ registered
Work in progress/ not registered
Parts car/ not registered
Parted Out/ Gone forever |
|
Or you can 
|
