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Suzuki - frm mx 01 (Page 1)

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Suzuki - frm mx 01
WE NEED DETAILS!
ALL RM MOTORCYCLES MUST BE REGISTERED THROUGH AMERICAN SUZUKI MOTOR CORPORATION FOR CONTINGENCY PAYMENT.
TWO OR MORE RACERS CANNOT SHARE ONE MOTORCYCLE. IN OTHER WORDS, ONLY ONE RACER CAN REGISTER IN THE PROGRAM,
QUALIFY FOR PAYMENT, AND RECEIVE PAYMENT PER MOTORCYCLE VIN#.
CIRCLE THE MODEL(S) YOU RACE, AND LIST THE LAST 9 DIGITS OF YOUR FRAME # (i.e., JS1RJ18C912100007):
RM80 RM125 RM250 Frame #
_ _ _ _ _ _ _ _ _
RM80 RM125 RM250 Frame #
_ _ _ _ _ _ _ _ _
RM80 RM125 RM250 Frame #
_ _ _ _ _ _ _ _ _
RM80 RM125 RM250 Frame #
_ _ _ _ _ _ _ _ _
RM80 RM125 RM250 Frame #
_ _ _ _ _ _ _ _ _
RM80 RM125 RM250 Frame #
_ _ _ _ _ _ _ _ _
EXAMPLE: RM80 RM125 RM250 Frame/VIN# 9 1 2 1 0 0 0 0 7
Please send a new release when you buy additional RM models.
RACING INFORMATION
Your Suzuki Dealer ________________________________________ City ______________________________ State ___________
Racing Classification(s) _______________________________________________________________________________________
Race Organization(s) _________________________________________________ Racing # _______________________________
I HAVE READ AND UNDERSTAND THE FOREGOING RELEASE.
Signature of Racer __________________________________________________________________ Date ____________________
Signature of Guardian (if racer is under 21 years)___________________________________________ Date ____________________
SPONSORED RIDER AFFIDAVIT
(If the motorcycle is owned by another individual, the "sponsor" must complete the sponsored rider affidavit.)
I have agreed to sponsor the rider listed on this form. I am the registered owner of the vehicle and understand that no additional person(s) other than
indicated will be paid contingency from American Suzuki Motor Corporation.
Owner's Name _______________________________ Owner's Signature _____________________________ Date _____________
Address _____________________________________________ City _________________________ State ______ Zip __________
If the motorcycle was a second party purchase, please provide a copy of the new owner registration.
SEND ONLY ONE FORM FOR THE CALENDAR YEAR. Remit to:
AMERICAN SUZUKI
P.O. BOX 1100
BREA, CA 92822-1100
ATTN: M/C CONTINGENCY

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