On-Line Add/Delete
Reporting Form

To make changes to your inventory, use your "TAB" key, NOT your "Enter" key to advance to each field.
*Indicates "required" field

  *CERT NUMBER:  
*COMPANY NAME:  
*YOUR NAME:  
*PHONE NUMBER:
 		  
 
Vehicle
Number		 Add or Delete
Vehicle		 Liability
 Yes or No		 Physical
Damage
 Yes or No		 VIN
 Requires "17" digits 		YEAR
 Example: "2005"

MAKE

 MODEL VALUE
*Required if Physical Damage
was added

1

ADD
DELETE

YES
NO

YES *
NO

2

ADD
DELETE

YES
NO

YES
NO
3 ADD
DELETE		 YES
NO		 YES
NO
4 ADD
DELETE		 YES
NO		 YES
NO
5 ADD
DELETE		 YES
NO		 YES
NO
6 ADD
DELETE		 YES
NO		 YES
NO
7 ADD
DELETE		 YES
NO		 YES
NO
8 ADD
DELETE		 YES
NO		 YES
NO
9 ADD
DELETE		 YES
NO		 YES
NO
10 ADD
DELETE		 YES
NO		 YES
NO

Comments:

 

 

CHANGES ARE EFFECTIVE THE DATE AND TIME YOU SUBMIT THIS FORM.


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