Condition of Vehicle

Excellent   Good Average Poor

 

Has the vehicle had bodywork or major repairs? Yes No

If yes where: Front End Rear End Fender Door Rear Quarter Panel Motor Transmission Rear End None  

Make & Model

Year:        Miles:

Enter your comments in the space provided below:

Tell us how to get in touch with you:

          Address:     City State: Zip

 

Phone:    Day Phone Fax

         

           Email     

          Best time to call Morning Lunch Afternoon Evening at Home Office

Please contact me as soon as possible regarding this matter.

                          Stanley M. Adams