Your Information
Name:

Email Address:

Phone Numbers:
Daytime Phone:

Evening Phone:

Best Time to Call:


How would you like us to contact you:
Day Phone   Evening Phone   E-Mail
Vehicle Information
Year

Make

Model

Trim Code (ex. SLE,GT,RS)

Engine

Mileage

VIN Number

Exterior Color

Interior Color

Additional Options

Transmission

Drive Type
2 Wheel Drive   4 Wheel Drive   All Wheel Drive
Interior Type
Leather  Cloth
Exterior Condition
Body Flawless Some Dents / Dings Damaged
Paint Glossy Dull / Chipped / Scratched Poor / Peeling
Trim / Chrome No Defects Pitted / Faded / Chipped Dull / Rusted / Missing
Glass No Defects Chipped / Pitted Cracked
Lights / Lenses No Defects Cracked Broken / Missing
Rust None Minor Through the Body
Hail Damage None Minor Major
On a scale of 1-10 rate your vehicles exterior:      
What needs to be fixed to make your car a "10":
Interior Condition
Upholstery Clean Stained / Worn Torn
Carpet Clean Stained Torn
Interior Panels Clean Faded Cracked / Damaged
Odor:
Smoke / Mold		 None Some Obvious
Air Conditioning Working Condition Not Installed Needs Repair
Power Accessories or Instruments All Operate     Repair or Replace Some
On a scale of 1-10 rate your vehicles interior:      
What needs to be fixed to make your car a "10":
Mechanical Condition
Engine Operates - No Leaks / Noises Some Minor Noises / Seepage Repair / Replace
Transmission Operates - No Leaks / Noises Some Minor Noises / Seepage Repair / Replace
Steering Tight / Trouble Free Loose / Noises Requires Repair
Suspension Unaltered and Trouble Free Altered / Worn Shocks Noisy / Loose
Requires Repair
Frame / Unibody Straight Repaired Damaged
Brakes Not Worn over 50% life Worn Pads less than 50% life Requires Repair
Tires
 Not Worn & Correct Size & All Match Some Wear & All Match Replace - Worn / Mismatch
On a scale of 1-10 rate your mechanical condition:        
What needs to be fixed to make your car a "10":  
Miscellaneous
Title-"Pink Slip" Clean Title History     Branded - "Salvage," "Flood," etc.
Registration Current Fees Required Expired
Service/Maintenance On Time & Current Some Done Not Done
Records All Available Some Available Not Available
Emissions/Safety Pass Some Work Needed Failed or Gross Polluter
Body Repair Done None Minimal Major
Body Repair Required None Minimal Major
What is the best /  worst part about your vehicle?
Any additional comments for us to help you get the best deal?