Saturday, July 4th, 2009
First Name
Last Name
Home Phone
Mobile Phone
E-mail Address
Best time to call
 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!