MAINE STATE POLICE Traffic Division Inspection Unit Inspection Sticker 20 State House Station Exchange and Refund Form Augusta, Maine 04333-0020 Phone: 207-624-8934 or 207-624-8935

Station Number ______

Station Name ______

Mailing Address ______

______

All stickers on hand at the end of a calendar year or at the end of a school bus inspection period must be returned to the Inspection Unit. Exchanges/Refunds will be given for FULL SHEETS of Motor Vehicle and Motor Vehicle E stickers, Commercial and Commercial E stickers, Trailer, and Motorcycle stickers. Exchanges/Refunds will also be given for individual School Bus stickers.

EXCHANGES TYPE # SHEETS TYPE #SHEETS

We are returning: Motor Vehicle Commercial Motor Vehicle E Commercial E Motorcycle School Bus Trailer

We want: Motor Vehicle Commercial Motor Vehicle E Commercial E Motorcycle School Bus Trailer

REFUNDS

We want a refund for ______(fill in number) stickers. Total due______

******SEE BACK OF FORM******

Office Use Only Below This Line

Rev. 10/2009 Please record the sticker sequence numbers in the form below. Please make sure to have them separated by type and in correct sequential order. When recording the beginning and ending sequence numbers, please make sure that any gap in numbers is recorded on a separate line.

Type of Sticker Beginning Sequence Ending Sequence Total Number of Stickers Number Number

Motor Vehicle

Motor Vehicle E

Motorcycle

Trailer

Commercial

Commercial E

School Bus

Partials

Motor Vehicle Commercial Motor Vehicle E Commercial E Motorcycle School Bus Trailer