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Telephone	A phone number is required.
	VEHICLE INFORMATION
Year
Make	____________________________ AEV Braun Braun NW Crestline Coach Demers E-One Excellance Frazer Horton Life Line Marque McCoy Miller Medtec Medix Miller Coach National Osage PL Custom Premier Road Rescue Southern Taylor Made Tri-Star Leader Wheeled Coach Medic Master Other / Unknown Remount Peach State Remount Life Star Remount Arrow Remount US Coachworks Triton Custom Truck & Body Works 1st Priority Renaissance Doctor Down Malley Industries Foundation
Model
Mileage
Box Length
Engine Type	____________________________ Gasoline Diesel Turbo-Diesel LNG or Hybrid
Transmission	____________________________ Automatic Manual
Drive System	____________________________ 2 Wheel Drive 4 Wheel Drive
Cab Access	____________________________ Walk Through Non Walk Through Window only
Asking Price
Inverter	Yes No
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