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The Tractor Registry

Registration Form

 

Make (Brand): _________________________________________

 

Tractor Model: ______________________ Tractor Serial Number: ____________________

 

Engine Model: ______________________ Engine Serial Number: ____________________

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Overall Condition (please explain):_________________________________________________

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Features & Options (please circle Y for Yes or N for No and fill in necessary blanks)

 

Transmission Type: _____________________________________ Number of Gears:_________

 

Hydraulics: Y N If yes, please indicate type:_____________________________________

PTO: Y N If yes, please indicate speed(s) (if known): __________________________

Belt Pulley: Y N

 

Electrical System Other Features and/or Comments on Features Already Listed

 

Starter: Y N __________________________________________________

 

Distributor: Y N __________________________________________________

 

Magneto: Y N __________________________________________________

 

Lights: Y N __________________________________________________

 

Fenders: Y N __________________________________________________

 

Cab: Y N __________________________________________________

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Owner Information:

 

IMPORTANT NOTE: The Tractor Registry List, which is to be published at various times as Brian Rukes sees fit, will be for sale to the public at some time. If you would like ANY of your personal information--including your name--withheld from that list, you may do so.

Please indicate here which items you would or would not like included in that list.

 

Name: ________________________________ Include in The Tractor Registry List? Yes No

 

Street Address/Box No.:___________________ (for my reference only)

 

Town: _________________________________ Include in The Tractor Registry List? Yes No

 

State or Province: ________________________ Include in The Tractor Registry List? Yes No

 

ZIP Code: ______________________________ (for my reference only)

 

Telephone Number: ______________________ (for my reference only)

 

E-mail Address: _________________________ (for my reference only)

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Please e-mail the completed form to:

 

"Brian Rukes" <mmregistry@yahoo.com>