Vehicle Offer Form Vehicle Offer Request -Complete the information below and we will e-mail you a Vehicle Offer within 1 to 2 Business HOURS between 9AM-9PM. -You can also Call Us 24 Hours/7 Days at (631)576-4848 for a Vehicle Offer.Owner Information Full Name* Zipcode where vehicle is located* Your Email (For us to send a Guaranteed Cash Quote)* Vehicle Information Year* Make* Model* Body Type*CAR - 2 DoorCAR - 4 DoorCAR - WagonSUV - 2 DoorSUV - 4 DoorVAN - Regular LengthVAN - Extended LengthPICKUP TRUCK - Regular CabPICKUP TRUCK - Extended CabPICKUP TRUCK - Crew CabOTHERWhat OTHER Body Type is your vehicle?* Trim Level -The "Trim Level" is also known as a "Sub Model" such as LX, GT, SE, LIMITED, etc. -Including this information will provide a more ACCURATE Vehicle Offer.Color* What is the approximate MILEAGE on the Odometer?* Do you have the TITLE for this vehicle?*Clean TITLE with NO LIENS SHOWN on FRONTTITLE WITH a LIEN SHOWN on FRONTLIEN on TITLE but have a LIEN RELEASESalvage/Rebuilt TITLEDo NOT have a TITLEDo you have KEYS for the vehicle?*YES, I have keysNo, I DO NOT have keysDo all the TIRES have air?*ALL Tires have air1 Tire is flat2 Tires are flat3 Tires are flat4 Tires are flatVehicle has MISSING WheelsWhere are the FLAT TIRES located on the vehicle?* Driver Side FRONT Passenger Side FRONT Driver Side REAR Passenger Side REAR Which WHEELS are MISSING?* Driver Side FRONT Passenger Side FRONT Driver Side REAR Passenger Side REAR Does the vehicle START at this time?*YES it startsIt will start with a jumpNO it will NOT startAre the Engine, Transmission and Battery complete under the hood?*YES - Engine, Transmission and Battery are COMPLETENO - Parts are NOT COMPLETEIs the BATTERY missing from the vehicle?*YES - Battery is missingNO - Battery is NOT missingAre the engine or transmission REMOVED from the car?*YES - ENGINE or TRANSMISSION is removedNO - ENGINE or TRANSMISSION are NOT removedWhat is missing under the hood?* Does the vehicle DRIVE at this time?*YES it drivesNO it will NOT driveDo you know why the vehicle will not drive?* Are any BODY PARTS (doors, bumpers, hood, etc.) LOOSE or MISSING from the vehicle?* YES No Where are the LOOSE or MISSING panels located on the vehicle?* Driver Side FRONT Passenger Side FRONT Driver Side REAR Passenger Side REAR Does the vehicle have any baseball-sized or larger DENTS or DAMAGE?* YES No Where are the DENTS or DAMAGE located?* Driver Side FRONT Passenger Side FRONT Driver Side REAR Passenger Side REAR Are any MIRRORS,GLASS or LIGHTS CRACKED or DAMAGED?* YES No Where is the CRACKED glass located on the vehicle?* Driver Side FRONT Passenger Side FRONT Driver Side REAR Passenger Side REAR Are any INTERIOR PARTS (seats, airbags, radio, etc.) MISSING from the vehicle?* YES No Does the vehicle have any FLOOD or FIRE damage?* YES No What is your ASKING PRICE for this vehicle?* (OPTIONAL) Include any extra information you would like us to know
