* Required Fields

First Name *

Last Name *

Contact Phone *

E-mail Address *

Best way to contact

	Air Conditioning		Alloy Wheels
	AM/FM Stereo		Cassette
	CD Player / Changer		Cruise Control
	Leather Interior		Navigation System
	Power Locks		Power Seats
	Power Steering		Power Windows
	Rear DVD Entertainment		Satellite Radio
	Spoiler		Sunroof

Year

Make

Model

Exterior Color

VIN

Mileage

Doors

Transmission

Drivetrain

Please rate the condition of the following on your vehicle from 1 to 10 (with 10 being mint condition).
Body (no dents, dings, rust, rot, damage)

Tires (no tread wear, mismatching)

Engine (no running conditions, burning oil, knocking)

Transmission / Clutch (no slipping, hard shifting, grinding)

Glass (no chips, scratches, cracks, pitted)

Interior (no rips, tears, burns, faded/worn, stains)

Exhaust (not rusted, leaking, noisy)

Was this vehicle ever a lease or rental return?

Is the odometer operational and accurate?

Are there detailed service records available?

Is there a leinholder?

If so, where is the leinholder located?

Who holds the vehicle title?

Does all equipment and accessories function correctly?

Did you purchase this vehicle new?

Please list all accidents this vehicle was involved in and the repair costs.

Please list any existing damage on this vehicle and where.

Please list any paint work performed on the vehicle.

Is the title designated "Salvage" or "Reconstructed?" List other title declarations, if any.

Comments

Please enter the six-digit code into the textbox
below to authenticate this form. If you do not enter
the code as it is shown, THE FORM WILL NOT SEND!