GM-DI Leasing Corporation
Request for Signage Change Form
Reason for Requested Change
Buy/Sell (Include lease assignment form*)
*Change in Paragraph 3rd
If Buy/Sell, has new dealer enrolled in CPO
*Stock Purchase
DBA name change only
Dealership Information
Current Dealership Name
New Dealership Name (If Applicable)
Yes
No
Other (See below)
BAC
BAC
Address where signs are installed
City
ST
Zip
Complete applicable sections below
Sign Removal
Remove All GMDI Signs
Has dealership terminated
NO
YES Termination date:
Remove the Following Sign(s)
Remove & Hold the Following Sign(s):
Consent of Landowner
New consent of Landowner form is required when Dealership Owner/Operator changes
Name Change
Dealer Name Panels to Read:
(Show Exact Lettering, Characters, and Hyphenation)
Franchise Change
Add:
Chevrolet
Cadillac
Buick
GMC
Delete:
Chevrolet
Cadillac
Buick
Pontiac
GMC
Hummer
SAAB
Face Change
Existing Sign:
Change To:
Existing Sign:
Change To:
Dealership Contact:
General Motors Zone Team Member Contact:
Printed
Name
Printed
Name
Phone #
Phone #
Fax #
Fax #
Email
Email
John Semeny
Fed Tax #
Signature
X
Signature
X
BOTH SIGNATURES REQUIRED TO PROCESS ORDER; PLEASE FAX COMPLETED FORM TO 866-418-9462
(or email: [email protected])
Revised 6/2014