Download as pdf or txt
Download as pdf or txt
You are on page 1of 2

ISSUED IN CONJUNCTION WITH A TEMPORARY TAG RECEIPT

EXPIRES:

MONTH DAY YEAR

NOTICE: THIS TEMPORARY TAG IS VOID UNLESS FULLY EXECUTED BELOW IN INK.
VALID FOR GROSS WEIGHT UNLADEN WEIGHT ONLY

ISSUED TO:___________________________________________________________________________________________________________
NAME CITY / STATE

ISSUED FOR:__________________________________________________________________________________________________________
YEAR MAKE MODEL VIN

ISSUED BY:___________________________________________________________________________________________________________
(IF BY DEALER USE COMPANY NAME) OF (COUNTY OFFICIAL) COUNTY CITY

ISSUED DATE:___________________________________________________DESIGNATED AGENT NUMBRE: ____________________________

You might also like