Empire Motor Group Trade-In Form

Empire Motor Group Trade-In Form
Date

Month Day Year
Today's Date
How did you hear about us? *
Applicant Information
Name *

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Car Trade-In Information

Put NA if the field in not applicable to your car
Are you the original owner of the car? *

Yes No
Do you have a California Registration? *

Yes No
Is the title paid off? *

Yes No
VIN# *
Pay Off Amount *
Year *
Make *
Model *
Miles *
Engine Condition *
Transmission Condition *
Dash Lights Condition *
How many miles are on your tires? *
Windshield condition? *

Cracked Pitted Starred Okay
Any accidents? *

Yes No
List any body damages *
List any car repaints *
Rate the condition of the car *

1

2

3

4

5

6

7

8

9

10

1 is Worst, 10 is Best
Rate the condition of the paint *

1

2

3

4

5

6

7

8

9

10

1 is Worst, 10 is Best
What is your asking price *
Round to the nearest dollar
Additional notes *
Should be Empty: