Form LF621 Texas

Evidence of Relocation Form

This document certifies that Dealer Legal Name, DBA has approval to relocate its dealership facility from Dealership Physical Address City State Zip Code to New Dealership Physical Address City State Zip Code. The dealer is authorized by Manufacturer/Distributor Legal Name to sell and service (check one: new motor vehicles designated as follows: AA Passenger Auto, AT All-Terrain Vehicle, UTV Utility Vehicle, AX Axles, LT Light Truck, MC Motorcycle, AB Ambulance, EN Engine, MT Medium Truck, MS Motor Scooter/Moped, BS Bus, TM Transmissions, HT Heavy Truck, NV Neighborhood Vehicle, FT Fire Truck, OT Other, ROV Recreational Off-Highway Vehicle, TR Towable RV, or a combination thereof) at the new facility. A new sales and service agreement will be executed to reflect the new location, with all provisions of the existing sales and service agreement remaining in effect at the new location. The authorized manufacturer's or distributor's signature, title, printed name, email address, and mailing address are provided.