Mail Form & A Copy of Your Drivers Lisence. 
Make Payment Out To:
Tina Burnette
111 Reagan St.

West Monroe,La. 71292
                                                                         Instructions

1. Must Have Power of Attorney Below and it must be notarized.In Persons Name that will be on Registration.

2. Must Have Copy of Current Insurance Card.

3.Must Have Copy of Drivers Lisence.

4. You Must Have Bill of Sale Made Out To You as Buyer and it must have your address and it must be notarized.
     It must include year, make, model, vin #, date, your name and address no exceptions.

5. Vehicles will only be titled in individuals names, No Business Names.

6. We Take Money Orders, Cashiers Checks, Personal Checks.

7. Make Payment To; Tina Burnette 111 Reagan st. West Monroe, La. 71292

______________________________    _______________________________________
Signature:                                                /  Date:
                                                                              Power Of Attorney


Date; _____________________


Known To All Men By These Presents, That,   (1.)__________________________________ (Name Of Individual)
Gives To Tina Burnette For An Indefinite period of time and until canceled in writing, The Power Of Attorney,
To Act in its behalf, In the state of Louisiana, on all matters pertaining to the registering of semi-trailers.
This Power of Attorney acts as our agreement to have any and all work pertaining to the license of any and all papers
pertaining to dealings with Motor Vehicle Department of the state of Louisiana. For This Service We agree to Pay all
Mutually agreed fees. This Power OPf Attorney Also Applies to the registration and/or Titling of Vehicles in the state
of Louisiana. This Power Of Attorney applies to any and all Vehicles.

Signed By;_________________________________________(Owner)   Date Of Birth;_____________________________

Personally Appeared the above named owner has acknowledged the foregoing instrument to be his/her free act and deed
In his/her said capacity.


Before Me;

_________________________________________
(Notary)

*Note: A Notary Public for statesa other then maine must note when there commision expires.


This Power of Attorney only gives Tina Burnette the right to sign their names where yours would appear when needed.
It Does Not Allow them to Sell, Trade, Lease, or in any other way, Utilize or Dispose of your Vehicles. They Can Not
sign Registration / Title Documents representing you unless the POA is on.
Mail Form & A Copy of Your Drivers Lisence.  318-801-9750
Make Payment Out To:
Tina Burnette
111 Reagan St.
West Monroe,La. 71292
Completed paper to mailed to this address;
Name; _______________________________________
Address; ______________________________________
City,State,Zip; _________________________________________
Daytime Phone; (_ _ _) _______________________________
Email;  ______________________________________________
Name title to be issued to; ________________________________
Address; ___________________________________
City,State,Zip; ________________________________________
Method of Payment;  __ Check    __ Money Order
Where did you learn of our services? __________________________

Please Check the options that apply to your vehicle; 
__2 Wheel Drive (Lt. Duty Trucks)                                __Power Brakes  
__Cassette                                                                          __Power Door Locks
__Bedliner (Trucks)                                                          __Power Seats
__4 wheel Drive ( Lt. Duty Trucks)                                __Power Steering  
__Premium Sound System                                             __Power Windows
__Dual Wheels (Lt. DutyTrucks)                                    __Rear Step Bumper ( Lt. Duty Trucks)
__3rd Seat                                                                            __Sliding Rear Window                 
__Compact Disc Player                                                    __CB Radio        
__Electric Defogger                                                           __Tinted Glass
__Anti-lock Brakes                                                             __Flip Up Sun Roof
__Tilt Wheel                                                                          __T-Top Roof
__Engine Brakes (Trucks)                                                __Electric Sun Roof
__4 Wheel disc brakes                                                       __Manual Sun Roof
__Air Conditioning                                                              __Roof Rack
__Fifth Wheel (Trucks)                                                       __Gas Engine
__Traction Control                                                              __Diesel Engine
__Air Ride Suspension (Trucks)            
__Heavy Duty Suspension (Trucks)
__Alloy Wheels                     
__Automatic Transmission                            
__Leather Seats
__A/M F/M Stereo                           
__Cruise Control                                       
__Plow Package (Lt. Duty Trucks)

Year;____________  Make; ____________________  Model; ________________ 
Body; ____________________     Color; ______________       # of Cylinders; _________      Mileage; ________________        
Serial (VIN) Number; ____________________________________
Rewrite or type Vin; ______________________________ (Must be clear) 
Price; $________________
If Motor Home Length;_________________    If Motorcycle CC'S; ______________________ If Truck Weight; _____________

Drivers Lisence Number; _____________________________________
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