Giveaway Drawing Entry

We Will Pay Your Car Payment Next Month ABC Ford wants to say thank you for visiting us and to show our appreciation, we will pay your car payment next month.* Name __________________________ Address_________________________________ City ___________________________ State ____ Zip Code _______________________ Phone _________________________ Cell ____________________________________ E-mail __________________________________________________________________ Vehicle of Interest __________________________________ New ____ Pre-Owned ___ Vehicle for Sale ____________________________________

__________________________________ Customer signature

___________________________________ Salesperson signature

Date _________________________________ -------------------------------------------------------------By signing this form I agree to allow Ford Motor Company to use this data for purpose of marketing to me in the future. For internal use only __ Selection __ Demonstration __ Service Walk __ Comparison __ Write Up __ Mgr T.O. __ Agreement __ Delivery *Details on Reverse

Back of entry form Maximum payment made from dealer to contestant winner may not exceed $500.00 No purchase necessary. Winner will be contacted before prize is awarded and MUST claim prize in person. All payments assume 30 days to next scheduled car payment NO refunds-additions-augmentations-remunerations-or substitutions All data collected may be used in future marketing