VEHICLE QUOTE FORM
Ana Lopez Phone: (631) 209-7794 E-Mail: ALopez@automaxli.com www.automaxli.com
Name
*
First Name
Last Name
E-Mail
*
Phone Number
*
City, State, and Zip of where vehicle will be registered
*
PREFERRED CONTACT METHOD
*
PHONE
E-MAIL
EITHER IS FINE WITH ME!
HOW DID YOU HEAR ABOUT US?
*
RADIO
MAILER/NEWSPAPER
REFERRED BY A FRIEND
SOCIAL MEDIA POST
INTERNET SEARCH
OUR WEBSITE
OUR STOREFRONT
I'M A CURRENT CLIENT
Other
INTERESTED IN...
Please complete all fields
VEHICLE TYPE
*
SUV
SEDAN
PICKUP
COUPE/CONVERTIBLE
I'M NOT SURE YET
PURCHASE TYPE
*
LEASE
FINANCE
CASH PURCHASE
I'M NOT SURE YET
MAKE
MODEL
TRIM LEVEL
EXTERIOR COLOR
INTERIOR COLOR
INTERIOR TYPE
*
LEATHER
CLOTH
NO PREFERENCE
MUST HAVES(Check all the apply)
*
Third Row
Second Row Captain Chairs
Sunroof
AWD/4x4
Leather
Rear Entertainment
Heated Front Seats
Remote Start
Tow Package
No Must Haves. I’m flexible with equipment
SPECIFIC OPTIONS/TRIM/EQUIPMENT REQUESTED IN NEW VEHICLE THAT MAY NOT BE LISTED ABOVE
IF LEASING: HOW MANY MILES/YEAR ARE NEEDED? (lower miles= lower monthly payment)
*
N/A
7,500
10,000
12,000
15,000
Other
MAXIMUM DOWN PAYMENT AVAILABLE (Inclusive of all taxes/fees)
*
DESIRED MONTHLY PAYMENT OR PAYMENT RANGE
*
ARE THERE CURRENTLY ANY LEASED VEHICLES REGISTERED TO YOUR HOUSEHOLD?
*
YES
NO
WHAT IS THE MAKE AND MODEL OF EACH LEASED VEHICLE IN YOUR HOUSEHOLD?
Name of any dealerships visited and amount quoted? (This is important because it may disqualify you for certain brokerage discounts)
ARE YOU, OR ANY HOUSEHOLD MEMBER, A FIRST RESPONDER?
*
YES
NO
ARE YOU, OR ANY HOUSEHOLD MEMBER, AN EDUCATOR?
*
YES
NO
ARE YOU ACTIVE MILITARY?
*
YES
NO
HAVE YOU GRADUATED COLLEGE WITHIN THE LAST 24 MONTHS?
*
YES
NO
ARE YOU A COSTCO MEMBER?
*
YES
NO
EMPLOYER NAME (Many companies are affiliates of auto manufacturers and offer additional incentives)
IF ALL GOES WELL I AM WILLING TO MOVE FORWARD...
*
TODAY
WITHIN A WEEK
BEFORE THIS MONTH ENDS
LONGER
TRADE/LEASE RETURN
YEAR
MAKE
MODEL
VIN NUMBER
DO NOT LEAVE BLANK
EXTERIOR COLOR
INTERIOR COLOR
CURRENT MILES
My Vehicle is equipped with: (Check all that apply)
Cloth Seating
Leather/Leatherette Seating
Sunroof
Navigation
AWD/4x4
Alloy Wheels Silver Wheels
Alloy Black/Grey Wheels
Rear Entertainment system
Blind Spot Warning system
Adaptive/Intelligent Cruise Control
Tow Hitch
Backup Camera
Second Row Captain Chairs
Manual Transmission
Other
ARE YOU OVER YOUR ALLOWED LEASE MILES
NO
YES
N/A
CURRENT MONTHLY PAYMENT
# OF PAYMENTS REMAINING
BANK CURRENTLY FINANCED/LEASED WITH
ACCOUNT NUMBER
Last 4 of Account Holder SSN
PAYOFF AMOUNT
PLEASE DECSRIBE ANY COSMETIC OR MECHANICAL ISSUES WITH THE VEHICLE?
Submit
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