Form 4 GMC S15 Sonoma
DATE: December 5, 2023
Driver's Information
Name:
Acme Trucking
Address:
123 Smallwood Place
City:
Richmond
Business Phone:
604.270.6121
Personal Phone:
514.725.6026
Vehicle's Information
Year:
2000
Maker:
GMC S15
Model:
Sonoma
Mileage:
127,442
Lic No:
123 ABC
Serial No:
see picture
Production Date:
8/31/1999
Comments:
NA
Insurance's Information
Clain No:
ATC S15 45
Deductible:
$500.00
Insurance Company:
Lizard (Geiko)
