9H46Q111881

a form has been submitted on March 26, 2011

Prototype-pilot registry form

Owner information
Your Name	JASON THOMPSON
Email	THOMPSONS122@CHARTER.NET
Street Address	140 RAYFORD CIRCLE
City	RUTLEDGE
State/Province	TN
Zip code	37861
Country	United States
Phone number	865 621 4012
Select all that apply:	Name , Email , Street Address , City , State , Zip code , Country , Phone number
Vehicle information
Select year	1969
Select make
Select model	Talladega
VIN	9H42Q111881
Body	63D
Color	M
Trim	QA
Date	09J
DSO	89
Axle	O
Trans	U
Original selling dealer	8920K FMC ADMIN SERVICES
Do you have a Marti report?	Yes
Do you have a build sheet?	No
Do you have a warranty identification card/ownercard?	Yes
Do you currently own this car?	Yes
Condition of car (please select one)	3
Comments	OWNED BY FORD MOTOR COMPANY UNTIL MARCH 1971 * MADE IN TO PROTOTYPE TALLADEGA BY FORD * LOANED TO VARIOUS FORD TEAMS TO LOOK AT * PAINTED PETTY BLUE AND USED FOR RICHARD PETTY PROMO * STILL HAS PETTY BLUE IN VARIOUS PLACES ON CAR TODAY SOLD TO NASCAR LEGEND BANJO MATTHEWS MARCH 1971 * BANJO KEPT AND DROVE THE CAR UNTIL HIS DEATH APROX 50K MILES BOUGHT BY JASON THOMPSON JULY 2010 *CURRENTLY ON DILAY AT THE FLOYD GARRETT NUSCLE CAR MUSEUM
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