REGISTRY Vehicle Data
***Factory Options/ Features Only***
Sequence# BS23JOB____________________

Exterior Color__________________________

Interior Color___________________________
Please include a legible pencil rubbing of your fender tag or write down the info as you see it on the tag. Whichever is easier.
Pick your options, one from each category
____4 Speed Pistol Grip
____Slapstick Automatic
____Column Shift Automatic

____Clear Glass-Full
____Tinted Class-Full
____Tinted Windshield only

____Radio Delete
____AM Radio
____AM/8 Track
____AM/FM Stereo

____Top-Matching Paint
____Vinyl Top-Boars grain
____Vinyl Top-Gator grain

____Vinyl Seats
____Cloth insert w/Vinyl 
        Seats      
____Leather w/ Vinyl Seats
       and overhead console
____Standard Gauges
____Standard Gauges w/ clock
____Rally Cluster Gauges

____Manual Steering
____Fast Ratio Power Steering
____ Standard Power Steering

____Standard Steering Wheel
____Standard Wheel w/ Horn Ring
____Rim Blow Steering Wheel

____15X7 Steel Wheels
____15X7 Rally Wheels

____Single Racing Mirror
____Dual Racing Mirrors

____3.55 Axle Ratio
____3.91 Axle Ratio


Individual Options- Check as applicable
____Light Package
____Rear Window Louvers
____Rear Shoulder Belts
____Seat Belt Group w/FSB
        Lamps
____Center Console
____Six Way Seats
____Floor Mats
____Bench Seat
____50 Amp Alternator
____70 Amp Alternator
____Defogger
____Variable Speed Wipers
 

____Pedal Dress Up
____Undercoating
____Front Chin Spoilers
____Headlight Time Delay
____Door edge moldings
____Sill Moldings (Rocker)
____Wheel Lip Moldings
____Sunroof
____Front Bumper Guards, ____Rear Bumper Guard Ins.
____ECS- California Emission
____Power Windows
____Rear Speakers
Other information________________________________________________

__________________________________________________________
 

 

 

 
Date_____________________
 
 
Signature_____________________
 
 
Please mail to this address
 
Jeff Bangert
123 Macintosh Drive
Palmyra Pa
17078