Registration Form for new Vehicles to be added to the Citroen 5HP (7.5hp) Register

Particulars:      
Name: First name:
Road: Telephone:
Postal zip code Country:
Town: Sign No:
e-mail: Date:
       
Vehicle Type:      
Chassis Serial number: Year of Manufacture:
Body Type: Chassis Type:
Engine number: Number of body: (if existing)
 
Technical Details:
Mudguard/Fender: Louvres:
Door: Wheelbase:
Length of running-board: Running-board:
Steering wheel: Spare wheel:
Steering wheel diameter: Coating:
 
Colour: Colour tint:
 
Dashboard:
Original instruments: Ammeter,light switch, ignition switch, choke
Additional instruments: Direction indicator and indicator light, speedometer, clock, charging lamp,
Headlamp Dipswitch dip/main,
 
Interior equipment: Imitation leather: Interior colour:
Carpet:    
Hood: Hood colour:
Tonneau cover: Side screens:
Windshield/Windscreen: Pivot:
Windscreen wiper:    
Headlights: Diameter:
Tail light:    
Wheels: Colour:
Type of rim: Wheel stud pitch circle diameter:
Length of the propeller shaft: Differential:
Shock absorber: Manufacturer: Hardford
No. of spring leaves front: 5, 7 No. of spring leaves back: 6, 8
Brakes: Front wheel brakes:
Cylinder head: Cylinder height:
Ignition: Manufacturer/Type:
Dynamo regulator: Carburettor/Type:
Fan: Radiator:
 
Original accessories: Lifting jack, oil can, tyre pump, Michelin rim wrench, fuel level gauge
Original tools: Tool kit, flat spanner for valve adjustment, Wakefield 225mm spanner, all-purpose pliers, double sided screwdriver, magneto adjustment spanner, magneto assembly spanner.
 
Condition/operation/maintenance:
Condition: Vehicle owned since:
Engine oil used: Gearbox oil used:
Rear axle oil used: Grease used:
Fuel used: Annual mileage:
 
Documents:
Original 5HP documents: Maintenance manuals, spare parts catalogue, Repair directory, workshop manual, colour swatch, postcards, advertisement posters,
Original leaflets: 1922, 1923, 1924, 1925, 1926.

T2/C, T2/C2, TL/C2, T2/C3, TL/C3, T3-1/C3, T3-2/C3, VL
Technical reports: Booklet:
Year of issue: Number: Page:
Title:
 
Restoration:
When last restoration completed: Restoration costs total:
Vehicle procurement: Parts procurement:
Repair costs: Documentation:
Estimated sales value: Currency:
 
Discrepancies:
 
Origin:
Former owner:
History: