Extension No. Trade name or xxxx of vehicle: .........................................................................
Extension No. Trade name or mark of vehicle: ..........................................................................................
Extension No. Trademark: ...................................................................................................................
Extension No. Trade name or mark of the power-driven vehicle ........................................................
Extension No. Section I 1. Make (trade name of manufacturer): .................................................................
Extension No. Trade name or mark of device: ....................................................................................
Extension No. Trade name or mark of vehicle: . . . . . . . . . . . . . . . . . . . .
Extension No. Trade name or mark of the motor vehicle ....................................................................