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Register a New Business Name in Texas

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					                                 AMERICAN FINANCIAL WARRANTY CORPORATION
                                                                     Service Payment Plan, Inc.
                                                              American Financial Warranty Corporation
                                                     P.O. Box 7719 - The Woodlands, Texas 77387 - 800.964.4811
                                             Remit weekly to insure contracts are in the system to provide coverage for your customers


                                                       Dealer Transmittal / Remittance Register
Dealership:                                       Dealer Acct. Number:                                        Prepared By:

Address:                                          City / State / Zip:                                         Phone #:
                                                                               New Business
                                                                                                                                                                         Amount Financed
     VSC Date   New /                                Contract           Plan                     Additional     Scheduled      Total                 Total Dealer Cost    (must at least
                          Customer's Last Name                                 Rate Card Cost                                             SPP Fee                          equal Total
      of Sale   Used                                 Number             Name                    Surcharges     Maintenance    Remitted              including SPP Fee
                                                                                                                                                                           Dealer Cost)

 1                                                                                                                                0
 2                                                                                                                                0
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25                                                                                                                                0
  CHECK #                                  New Business Totals                 $        -       $       -     $          -   $        -   $   -     $              -      $       -

        MT 8000 (02/08)

				
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