Free 53606.FH11 - Indiana

TEMPORARY PLATE LOG
State Form 53606 (5-08) SECRETARY OF STATE, DEALER DIVISION

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Pursuant to 75 IAC 2-2-13, this record must be kept on file for a period of three (3) years. NAME OF PURCHASER ADDRESS OF PURCHASER CONTROL NUMBER YEAR, MAKE, & MODEL OF VEHICLE VEHICLE IDENTIFICATION NUMBER (VIN) ISSUE DATE EXPIRATION DATE
(month, day, year)

(number and street, city, state, & ZIP code)

(month, day, year)