First Name
Last Name
Email
Phone
Address
City
State
ZIP
Vehicle Year
Make
Model
Doors 2 Door4 DoorHatchback
Trim Level (if known)
Interior Color
Exterior Color
Cylinders
Liters
Mileage
VIN
Transmission AutomaticManual
Lien Holder
Estimated Payoff
AM/FM RadioCassetteCDCD ChangerPower WindowsPower LocksA/CRear A/CABSCruise ControlTilt ControlRoof RackSunroofAlloy WheelsDrive TrainTow PackageDual Air BagsSide Air BagsPower Seat(s)Leather Seating
Metal/Paint (Scratches, dings, dents, rust, fading) PoorAverageExcellent
Tires (50% tread wear - replacement) PoorAverageExcellent
Upholstery (Tears, burns, stains) PoorAverageExcellent
Glass (Fractures, spiders, chips) PoorAverageExcellent
Clutch (Clutch slipping) PoorAverageExcellent
Brakes (Squeaky, noisy) PoorAverageExcellent
Has your vehicle ever been involved in a collision?
YesNo
If yes, was a Body Shop estimate of repairs written?
N/AYesNo
Were Body Shop repairs performed?
Was the vehicle repaired to your complete satisfaction?
Are any of the painted surfaces scratched, rusted, or faded?
Are there any dents and dings?
Have any of the painted surfaces been repainted or touched up?
Does any of the glass have fractures, spiders, or chips?
Does the upholstery have tears, burns, or stains?
Does the stereo system or any of its components need repairs?
Do all of the gauges and dash functions work?
Does the engine need any repairs?
Does the transmission need any repairs?
Is the clutch slipping or need any repairs?
Are the brakes squeaking or in need of repair?
Has the transmission or engine ever been replaced?
Has the vehicle ever been a taxi, rental car, or police car?
Has the vehicle ever been in water deeper than the midpoint of the tires?
Has the vehicle ever been declared a Flood vehicle?
Is the vehicle's frame in need of repair?
Has the vehicle ever had a salvage title?
Is this a lemon law buyback vehicle?
Has the vehicle ever been declared a total loss?
Is the vehicle air bag in working order?
Has the vehicle air bag ever been deployed?
Do you have any of the service records for this vehicle?
Do you have records for any oil change within the last 5000 miles?
Is the catalytic converter attached and working properly?
Are the inspection stickers current?
Has the spare tire ever been used?
Do any of the tires need to be replaced?
Is the pollution control equipment attached and working properly?
Is there anything else we should know about this vehicle?
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