We Will Pay Your Car Payment Next Month

ABC Ford wants to say thank you for visiting us and to show our appreciation, we will
pay your car payment next month.*

Name __________________________ Address_________________________________

City ___________________________ State ____ Zip Code _______________________
Phone _________________________ Cell ____________________________________
E-mail __________________________________________________________________

Vehicle of Interest __________________________________ New ____ Pre-Owned ___

Vehicle for Sale ____________________________________

__________________________________ ___________________________________
Customer signature Salesperson signature

Date _________________________________

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By signing this form I agree to allow Ford Motor Company to use this data for purpose of
marketing to me in the future.

For internal use only

__ Selection __ Demonstration __ Service Walk __ Comparison __ Write Up __ Mgr T.O. __ Agreement __ Delivery

*Details on Reverse

Back of entry form

Maximum payment made from dealer to contestant winner may not exceed $500.00 No
purchase necessary. Winner will be contacted before prize is awarded and MUST claim
prize in person. All payments assume 30 days to next scheduled car payment
NO refunds-additions-augmentations-remunerations-or substitutions
All data collected may be used in future marketing