APPENDIX II RECORD OF TRANSACTION

Dealer certificate No.                No.            

         (Printed on form)      (Transaction number printed

                     on form)

(1) Description of property -    

(2)                   , 19___         (3)            

   (Date)                  (Name of dealer/employee)

(4)                           , 19____

   (Name of customer)            (Date of birth)

                  ,            

   (Driver's license no./             (Street address)

   Mich. personal ID no.)

                     ____________________

                     (City & State)   (Zip)

(5)                  

   (Price paid)

(6)                     

   (Check number, bank draft

   number, money order number

   or cash)

   Thumbprint                           

                     (Signature of customer)

(Ord. 415. Passed 9-8-81.)