I/WE DO HEREBY GRANT TO ROBERT BURCHETT OF TAG MAN AUTOMOTIVE TITLE SERVICE, POWER OF ATTORNEY TO ACT ON MY/OUR BEHALF TO COMPLETE AND SUBMIT AN APPLICATION FOR TITLE AND/OR REGISTRATION FOR THE VEHICLE BELOW.
VEHICLE IDENTIFICATION NUMBER ____________________________________________
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PRINTED OWNER'S NAME PRINTED CO-OWNER'S NAME
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OWNER'S SIGNATURE DATE CO-OWNER'S SIGNATURE DATE