Autosweep RFID - Vehicle Assignment Form PDF

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A UTOSWEEP RFID SUBSCRIPTION

Vehicle A ssignment Form

Account Name :
VEH ICLE INF ORMATION
M ake - M odel Col or - Year P l at e N o Cl as s RFID S t i c ker N o. Ac c ou n t N o

____ - _ - _ ____ _ 0000000000 000000

__________ - ___________ ______ - _____ __________ _____ 0000000000 000000
__________ - ___________ ______ - _____ __________ _____ 0000000000 000000
__________ - ___________ ______ - _____ __________ _____ 0000000000 000000
__________ - ___________ ______ - _____ __________ _____ 0000000000 000000
__________ - ___________ ______ - _____ __________ _____ 0000000000 000000
__________ - ___________ ______ - _____ __________ _____ 0000000000 000000
__________ - ___________ ______ - _____ __________ _____ 0000000000 000000
__________ - ___________ ______ - _____ __________ _____ 0000000000 000000
__________ - ___________ ______ - _____ __________ _____ 0000000000 000000
__________ - ___________ ______ - _____ __________ _____ 0000000000 000000
__________ - ___________ ______ - _____ __________ _____ 0000000000 000000
__________ - ___________ ______ - _____ __________ _____ 0000000000 000000
__________ - ___________ ______ - _____ __________ _____ 0000000000 000000
__________ - ___________ ______ - _____ __________ _____ 0000000000 000000
__________ - ___________ ______ - _____ __________ _____ 0000000000 000000
__________ - ___________ ______ - _____ __________ _____ 0000000000 000000
__________ - ___________ ______ - _____ __________ _____ 0000000000 000000
__________ - ___________ ______ - _____ __________ _____ 0000000000 000000
__________ - ___________ ______ - _____ __________ _____ 0000000000 000000
__________ - ___________ ______ - _____ __________ _____ 0000000000 000000
__________ - ___________ ______ - _____ __________ _____ 0000000000 000000
__________ - ___________ ______ - _____ __________ _____ 0000000000 000000
__________ - ___________ ______ - _____ __________ _____ 0000000000 000000
__________ - ___________ ______ - _____ __________ _____ 0000000000 000000
I hereby certify that the information provided above is true, correct and complete. I voluntarily disclose my personal information for the
fulfilment of my Autosweep RFID account management. I understand that any false, misleading, incorrect or withheld information may cause the
disapproval or termination of the contract for the Autosweep RFID Services.

__________

Customer's Name Signature Date

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