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Made in U.S.A.

Agreement to Furnish Insurance Policy

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Protect yourself and your customer. This form helps ensure that all sold vehicles will have insurance. This form is a must have! • 8-1/2” x 7” • 4-part, snap-out • Carbonless - White, Canary, Pink, Goldenrod • Prints in Blue and Red ink • Packaged 100 per pack • Quantity price breaks are: 1, 3, 5, 10, 20 packs

#4810 Print alignment matches R&R* form 228RS-U

* R & R is a registered trademark of The Reynolds and Reynolds Company.

Made in U.S.A.

Agreement to Provide Insurance

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• 8-1/2” x 7” • 3-part, snap-out • Carbonless - White, White, White • Prints in Black and Red ink • Packaged 100 per pack • Quantity price breaks are: 1, 3, 5, 10, 20 packs

#4811

Made in U.S.A.

GM Customer Incentive & OnStar Acknowledgment • 8-1/2” x 11-3/4” • 2-part, snap-out • Carbonless - White, Canary • Prints in Black ink • Packaged 100 per pack • Quantity price breaks are: 1, 3, 5, 10, 20 packs

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#7270 (Form #GM-3795-OS)

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