HCI Building Repo Form
Dealership Name
*
Dealership City
*
Dealership State
*
Dealer Email
*
example@example.com
Dealer Phone Number
*
Please enter a valid phone number.
Date Delivered
*
-
Month
-
Day
Year
Date
Previous Customer Name
*
Building Serial #
*
Building Size
*
Building Color
*
Does the building need repairs?
*
Yes
No
If the building needs repairs, include list of primary damage to asset.
Upload Photos of Repairs Needed for Approval.
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of
Upload Photo of Itemized Repair Quotes for Approval.
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Upload Photos of Building Including All Sides (outside, all interior, any proof of damage, etc.)
*
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Suggested Retail Price
Repo is classified as:
Managed Inventory
Buy Back
Upload Pick Up Request Form
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Additional Comments
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Should be Empty: