ATC Truck Info. Form
Make
*
Please Select
Ford
Chevy
GMC
Isuzu
Chrysler
Dodge
BMW
Other
Make (Other)
Type in Make if other selected above
Year
*
August and later are considered next year model
Model
*
Please Select
E-250
E-350
F-350
F-450
F-550
F-650
F-700
F-800
C1500
C2500
C3500
C4500
Grand Caravan
Other
Model (Other)
Type in Model if other selected above
Truck #
If there is one.
Truck Nickname
If it has one.
VIN#
Truck Type
*
Please Select
Bucket Truck
Box Truck
Picup Truck
Van
Minivan
Bucket Van
Sprinter Van
Flatbed
Other
Truck Type (Other)
Type in Truck Type if other selected above
Boom Type
Please Select
AT-200 (35' Squirt)
AT-235 (42' Squirt)
37G (42' Insulated)
T-40
Telsta 28' Squirt
Altech 28' Squirt
Dura Lift 28' Squirt
Versalift 28' Squirt
Other
Boom Type (Other)
Type in Boom Type if other selected above
Pic. of Odometer
*
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Pic. of Vin Tag/Sticker
*
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Pic. of License Plate
*
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Can you find Registration?
*
Please Select
Yes
No
Pic. of Reg.
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Can you find Insurance Card?
*
Please Select
Yes
No
Pic. of Ins. Card
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Pic. of Inside
*
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Pic. of Oil Dipstick
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Before Cranking
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Engine Type
*
Please Select
4.9 Gas (300)
5.7 Gas (350)
7.4 Gas (454)
5.3 Gas
6.0 Gas
8.1 Gas
5.8 Gas (351)
7.5 Gas (460)
5.4 Gas
6.8 Gas (V10)
6.2 Diesel GM
6.5 Diesel GM
6.6 Diesel GM (Duramax)
7.3 Diesel (Powerstroke)
6.0 Diesel (Powerstroke)
6.4 Diesel (Powerstroke)
6.7 Diesel (Powerstroke)
5.9 Diesel (Cummins)
6.7 Diesel (Cummins)
8.3 Diesel (Cummins)
Other
Not Sure
Engine Type (Other)
Pic. of Left side
*
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Pic. of Right side
*
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Pic. of Back
*
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Pic. of Front
*
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Does it run?
Please Select
Yes
No
Not Sure
Is this unit equipped with any of the following? Check all that apply.
*
Harness
Safety Cones
Construction Signs
ATC Magnetic Signs
NA
Is this unit equipped with any of the following? Check all that apply.
*
Working Power Inverter
Working A/C
Working Heater
Working Radio
Not Sure
Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Notes
Name of Driver
If Known
Form Submitted by:
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