Versalift Model

Aerial S/N

Demo #

Chassis Model

VIN (last 8 digits)

Mileage

Please Answer All Of The Following Questions:

• Choose an option Yes No   A complete annual inspection was done at check in and reported to Time Manufacturing Company


• Choose an option Yes No   A dielectric test was performed at check in and reported to Time Manufacturing Company


• Choose an option Yes No   An oil and filter change was done at check in and reported to Time Manufacturing

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This unit will be ready for pickup on:

Location

Please list the customers that this machine has been shown to over the last 2 weeks:

Customer Name

State

Customer Name

State

Customer Name

State

Customer Name

State

Customer Name

State