Registration Form

Australian Allis Chalmers Register

http://aussieallischalmersregistry.blogspot.com.au/

NAME:                                                                                                     

 

ADDRESS:                                                                                                   

 

PHONE:                                                                                                         

 

EMAIL:                                                                                                             

Can the Tractor/Machine information be added to the public register?     YES   /   NO

Would you be happy to share contact details with fellow owners on the register? YES /  NO

TRACTOR MODEL:                                                                                                      

 

SERIAL NUMBER:                                                                                                          

 

ENGINE NUMBER:                                                                                                          

 

CONDITION:                                                                                                                 

 

ANY HISTORY/ PREVIOUS OWNER/ SELLING DEALER?:                                           

                                                                                                                                         

 

                                                                                                                                          

 

TRACTOR MODEL:                                                                                                     

 

SERIAL NUMBER:                                                                                                        

 

ENGINE NUMBER:                                                                                                       

 

CONDITION:                                                                                                                 

 

ANY HISTORY/ PREVIOUS OWNER? SELLING DEALER?:                                     

                                                                                                                                      

 
                                                                                                                                      


Signed:                                                              Date: