Registry Datasheet

Owner Information

PLEASE NOTE: There's no charge for registry membership and all personal or contact data disclosed by registry participants will be considered confidential and as such, will not be distributed, posted or forwarded to any third party without specific written permission (including e-mail) from the RSA owner concerned.

Name:  
Address:  
Address:  
City:  
State/Province:  
Zip/Postal Code:  
Country:  
Phone Number:  
E-mail Address:  


Vehicle Information

Vin #
(See black data plate on driver's door jamb - below the latch)
 
 
Manufacturers date code
(See top RH corner of black data plate on driver's door jamb - below the latch)
Select Month   Select Year
 
 
Vehicle Color
Select Exterior color Interior trim color seatbelts/doorpulls
 
If exterior is “color to sample”, or interior trim is “other” please specify color
 
 
When did you purchase the car?
(Approx. date)
  Select Day     Select Month     Select Year
   
 
Are you the original owner?
    First
    Second
    Third
    Fourth
    Other/Don't know
 
Previous owners name (or name of the person you purchased it from)
 
 
Previous owners State of Residence
 
 
What was the approximate mileage of your when you purchased it?
 
 
What is the current mileage of your ?
 
 
What were the factory options originally fitted your ?
(See 3 digit option codes on bottom of ID label under front hood - should start with “C02”)
    [650] Sunroof
    [573] Air-Conditioning
    [220] Limited Slip
    [331] Radio/Cassette
    Other
Please specify code number:
 

Vehicle Usage (by approx. percentage)
Street/Track/Autocross/Time Trial/Concours
 


Vehicle Modifications
For example: Roll Cage/5 Pt harness/Turbo brakes/upgraded springs
headers/muffler bypass/wider wheels/etc.
 


Additional Data
Please provide any additional data on car and driver
(e.g. PCA Region, competition successes, awards, events attended)
 

NOTE: PLEASE PRINT A COPY OF YOUR DATASHEET [this page] for your records BEFORE you click
the SUBMIT button below - which will submit your data by e-mail (your e-mail program must be open on your computer).

 

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