ROUTE 51 SOUTH · P.O. BOX 445 · PERRYOPOLIS, PA 15473

PHONE: (724) 736-4445 · 1-800-735-5288 · FAX: (724) 736-0466

 

 

REPRESENTATIVE’S AUTHORIZATION

 

 

Dealership Name _______________________________________________________________

 

Owner’s Name _________________________________________________________________

 

 

    I hereby authorize:

 

 

to be my representative(s) at the Perryopolis Auto Auction.  This means I will be fully responsible for every transaction that he/she transacts at the Perryopolis Auto Auction, including any transactions involving odometer tampering.

 

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OWNER’S SIGNATURE

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ADDRESS

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DATE