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UTV Engine Information
A copy of your responses will be emailed to you. Please print this email and keep it with UTV/engine for presentation to tech officials at track.
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* Required
Email
*
Your email
Have you submitted a UTV Engine Builder Agreement (if no, this must be done before filling out this document)?
*
Yes
Not required as I have a stock OEM or existing engine that will be sealed by officials
Approved Engine Builder Name or N/A if stock/existing engine
*
Your answer
Driver Name, Class, and Vehicle number
*
Your answer
Engine Make, Type, and Model Year
*
Your answer
OEM Engine Serial Number (VIN #)
*
Your answer
LOORRS Seal Serial Number
*
Your answer
Date Sealed
*
MM
/
DD
/
YYYY
I certify on penalty of disqualification from engine builder program that this engine meets all engine rules as specified in the current LOORRS/LORORS UTV Rule book as of the date I installed the seal or presented the engine to tech for sealing.
*
Yes
No
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