Date of Purchase :             First Name: *           Last Name: *           Address *           Zip Code: *           City/State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming *           *Phone: *           * Email: *           Fax:             Website:             Make: *             Model: *             *Vin Number: * ! Must be 17 digits ! *             Notary: Yes (+$15 Fee) (If your state requires notary, you will be contacted for billing information.) No             Bill of Sale: Yes (If yes, please complete the following:) Amount you or your customer paid: Name and Address you want on the Bill of Sale: Leave Bill of Sale address and amount blank so I can fill it in myself: Yes No No, my state does not require a Bill of Sale             Odometer Reading             Shipping & Handling Over Night (+$45 Fee) You will be contaced for billing information.               If you have purchased more than one scooter, you may enter additional VIN#s in the comments box below. Make sure you list the model number and make next to each VIN# number or we will have to contact you for this information, which could delay your request.       Example:       VIN: L5JT123YTP2300349, (Model# from website) mpw-3016-150, (Name)Capri 150cc VIN: L5JT85940Y09P8003, mpw-3012-250, Bali 250cc               Comments:                     Please double check that you have entered your 17 digit VIN number correctly!