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Client Information:

* Denotes required fields

* Dealer Name:
* Contact Name:
* Title:	-- Please Select -- General Manager Dealer Principal Sales Manager Service Manager
* Contact Email:
* Address:
* City:
* State:	Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
* Zip:
* Region:	-- Please Select -- Boston Region Central Atlantic Toyota Chicago Region Cincinnati Region Denver Region Kansas City Region Los Angeles Region New York Region Portland Region San Francisco Region GST Region Gulf States Toyota
Terms: GS Marketing will take Dealer's customer address information and append e-mail addresses.  Dealer will only pay for those email addresses that are successfully matched. Appended address data will be delivered back to Dealer approximately 4 weeks after receipt of customer data. Dealer will be charged 40¢ for each successfully appended customer email address. Full payment to GS Marketing will be due within 30 days of final delivery of appended data. Data will be extracted from the Dealer's database of owners and parts and service customers By completing and submitting this Sales Agreement Form, you agree to the terms stated above.