Name: ____________________________________________		Email: ________________
Address:___________________________________________
City: ___________________	State: ________________	Zip: ____________________
Area Code: ______________	Phone: __________________	Fax: ____________________

Vehicle Information

License: ______	Vehicle ID: _____________________________________
Year: _____	Make: ______	Model: ______
Engine: _______	Transmission: _______	Length of ownership: ______
Odometer: ________	Actual Mileage: ________	Purpose of appraisal: ______
Insurance Co: ____________________________________

Equipment

Automatic Transmission: ____	Tilt steering wheel: _____	Power steering: _____
Air conditioning: _____	Leather: ______	Power windows: _____
ABS Brakes: _____	Sunroof: _____	Power Door locks: ____
Sound: ______	Cruise control: _____	Power seats: ______
Other Factory Options: ________________________________________
Modifications: ______________________________________________

Condition Report

Body: __________________	Glass: _________________	Drive train: ____________
Paint: __________________	Interior: ________________	Wheels & Tires: ________
Chrome: ________________	Engine: ________________

Attach additional vehicle information if necessary.

Describe known problems: _____________________________________________
____________________________________________________________________

Do you have an opinion of the value? $___________ How much invested? $___________

Signature ___________________________________________

Using the the following descriptions rate the vehicles overall grade: _______________

A - EXCELLENT, B - VERY GOOD, C - GOOD, D - POOR, F - VERY BAD