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2025-09-23 17:08:15

NEW OWNER (FULL LEGAL NAME) *

EMAIL ADDRESS *

TELEPHONE # *

PURPOSE *

VEHICLE INFORMATION:

PURCHASE DATE (If Available) *

YEAR OF VEHICLE *

MAKE *

MODEL *

VIN # (Double Check For Error) *

ODOMETER (KM) *

COLOUR *

# OF CYLINDERS *

TRANSMISSION (AUTOMATIC/MANUAL) *

# OF DOORS *

OPTIONS *

None Power Steering Power Brakes Power Windows Power Locks Power Seats Cruise Control A/C

VEHICLE CONDITION:

Include problems before repairs were done (excess wear & severe damage, not regular maintenance).

MECHANICAL PROBLEMS (Part 1)

EXAMPLES: Engine (seized, misfiring, knocking, oil leak), Transmission (seized, slipping gear, rough shifting/clunk, clutch worn, oil leak), Power Train (drive shaft, differential/awd, drive axle, transfer case fail/leak), Electrical (alternator, starter worn/failed), Turbo/Super Charger (fail), Hybrid/Electric Battery (fail), Cooling (radiator, condenser, fan, water pump failed/leak),

Comment [Point Form Notes] *

MECHANICAL PROBLEMS (Part 2)

EXAMPLE: Exhaust (manifold, O2 sensor, cat, resonator, muffler, pipe leak/failed), Suspension (strut/shocks, springs, control arm, sway bar, knuckle worn/leak), Steering (rack, gearbox, pump, tires worn/leak), Braking (pads/rotors, master cylinder, caliper, parking/hand brake, line worn/leak), Fuel (gas leak, pump failed).

Comment [Point Form Notes] *

BODY PROBLEMS & EXACT LOCATION

EXAMPLES: Bumper, Fender, Hood, Roof/Sunroof, Door, Wheel Well, Quarter Panel, Trunk/Liftgate, Rear Bumper, Rim, Window/Windshield, Light, Mirror, Grille [Rust, Scrape, Dent, Crack, Paint/Clear (faded/peeling/mismatch)]

Comment [Point Form Notes] *

INTERIOR PROBLEMS & EXACT LOCATION

EXAMPLES: Options/Features Inoperable (Power Windows, Power Locks, A/C, Entertainment System, Tachometer), Dash Lights (Check Engine Light, Airbag Light, ABS Light), Carpet/Seats/Roof Liner (Ripped, Stained), Panels/Trims (Cracked/Damaged) And Etc.

Comment [Point Form Notes] *

PREVIOUSLY OUT OF STATE OR COUNTRY? *

PREVIOUS RENTAL OR COMMERCIAL USE? *

PREVIOUS ACCIDENT HISTORY? *

VEHICLE VALUATION:

PURCHASE PRICE *

SPECIAL INSTRUCTIONS/comments/notes *

TERMS AND CONDITIONS:

By clicking submit, I agree that the information I have provided on this motor vehicle is accurate to the best of my knowledge. Click submit to send the form and proceed to Step 2: Complete Payment ($49.95).

Submit

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