Name*:
 
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Membership No. (if applicable):
 
Current registration mark:
 
Date purchased:
 
Chassis No:
 
Engine No:
 
Engine size and/or hp rating:
 
Rhd or lhd:
 
Colours:
 
Wheel size:
 
Country of origin:
 
Month/year of manufacture:
 
Country from which imported if applicable):
 
Year imported:
 
Condition:
 
Please describe any modifications from standard including body builder (if not Ford), and any other comments concerning this vehicle: