LS5 Registry Form

E-mail Address: *
Your Name *
Street Address 1 *
Street Address 2
City *
State, Province or Territory *
Zip Code *
Comments Such as owned since...
Trim Tag Date (e.g. 01A)
Final Assembly Plant *
Body Number *
Interior Trim Code * Please note if A51 (bucket) or A52 (bench)
Exterior Paint Code(s) *
Transmission Type *	M22 4-Speed M40 TH400
Cowl Induction - Y/N ? *	Yes No
Model year *
VIN (complete) *
Dealer Name
Sched No & Date From Block 10 of buildsheet (e.g., 11 12-15)

Verification Code:
Enter Verification Code: *


* Required

Trim tag example:
LS5 Registry

Buildsheet example:
Block #10 of build sheet