Order Form

1
Unique ID
2
Customer Type* This field is required.
Please Select
Please Select
New
Existing
3
Company or Account Name* This field is required.
4
Are you EORI Registered* This field is required.
Yes
No
5
EORI Number
6
Type of Order* This field is required.
Collection only (vehicle returned to Gilpin's Yard for collection)
Delivery only (vehicle dropped at Gilpin's Yard for delivery)
Collection and delivery
7
Date collection available from* This field is required.
8
Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
9
Email* This field is required.
example@example.com
10
Phone Number* This field is required.
Area Code
Phone Number
11
Make and Model* This field is required.
12
Registration
13
Buyers Name* This field is required.
14
Customer Member Number* This field is required.
if private enter n/a
15
Lot Nr* This field is required.
if private enter n/a
16
Collect From* This field is required.
Please Select
Please Select
** Gilpins Yard**
** Customers Address**
NI-Armagh IAA
NI-Antrim (Ecopart) IAA
NI-Ballynahinch IAA
NI-Belfast Copart
NI-Moneymore IAA
NI - OTHER (SEE NOTES BELOW)
ROI-Castledermot Copart
ROI - OTHER (SEE NOTES BELOW)
SC-Addiewell IAA
SC-Carluke IAA
SC-East Kilbride Copart
SC-Edinburgh BCA
SC-Glasgow BCA
SC-Glasgow-East BCA
SC-Glasgow IAA
SC-Livingston BCA
SC-St Boswells (Euroroute) IAA
SC- OTHER (See notes Below)
NW-Chester Copart
NW-Manchester BCA
NW-Newcastle BCA
NW-Preston BCA
NW-St Helens Copart
NW- Oldham IAA
NW - OTHER (see notes below)
NE-Northumberland IAA
NE-Peterlee Copart
NE-Teesside IAA
NE-Whitburn Copart
NE - OTHER (See notes below)
YS-Brighouse BCA
YS-Doncaster Church Lane IAA
YS-Doncaster Planet Road IAA
YS-Doncaster Wellsyke BML IAA
YS-Huddersfield Cooper Bridge IAA
YS-Leeds BCA
YS-Wakefield (Yorkshire) AB
YS-York – Copart
YS - OTHER (See notes below)
EM-Bury St Edmunds IAA
EM-Corby BCA
EM-Corby-(Baird-Road) BCA
EM-Corby Co Part
EM-Donington Park (East Midlands) AB
EM-Nottingham BCA
EM-Sandtoft IAA
EM-Thurleigh BCA
EM - OTHERS (See notes below)
WM-Birmingham-Perry-Barr BCA
WM-Measham BCA
WM-Prees Heath (Shropshire) AB
WM-Sandtoft Copart
WM-Stafford IAA
WM-Walsall BCA
WM-Wolverhampton BCA
WM-Wolverhampton Copart
WM - OTHER (See Notes below)
SE-Banbury IAA
SE-Bedford BCA
SE-Blackbushe BCA
SE-Crawley BCA
SE-Paddock-Wood BCA
SE-Sandwich Copart
SE-Southampton (Silverlake) IAA
SE - OTHER (See notes below)
SW-Bristol BCA
SW-Bristol Copart
SW-Bristol IAA
SW-Bridgwater BCA
SW-Gloucester Copart
SW-Gloucester IAA
SW-Newbury Copart
SW-Truro IAA
SW-Wellington Anchor Services IAA
SW-Westbury (Wiltshire), AB
SW-Westbury Copart
SW-Winsford IAA
SW - OTHER (see notes below)
LND-Chelmsford (Essex) AB
LND-Canvey Island IAA
LND-Enfield BCA
LND-Newark IAA
LND-Newbury IAA
LND-Peterborough IAA
LND-Warley - M25 IAA
LND - OTHER (See notes below)
AN-Colchester Copart
AN-Rochford Copart
AN-Sandy Copart
AN-Wishbech Copart
AN - OTHER (See notes below)
NI - Northern Ireland, ROI - Republic of Ireland, SC -Scotland, NW - North West, NE - North East, YS - Yorkshire, EM - East Midland, WM - West Midlands, LND - London, AN - Anglia, SE - South East, SW - South West
17
Deliver to* This field is required.
Please Select
Please Select
** Gilpins Yard**
** Customers Address**
NI-Armagh IAA
NI-Antrim (Ecopart) IAA
NI-Ballynahinch IAA
NI-Belfast Copart
NI-Moneymore IAA
NI - OTHER (SEE NOTES BELOW)
ROI-Castledermot Copart
ROI - OTHER (SEE NOTES BELOW)
SC-Addiewell IAA
SC-Carluke IAA
SC-East Kilbride Copart
SC-Edinburgh BCA
SC-Glasgow BCA
SC-Glasgow-East BCA
SC-Glasgow IAA
SC-Livingston BCA
SC-St Boswells (Euroroute) IAA
SC- OTHER (See notes Below)
NW-Chester Copart
NW-Manchester BCA
NW-Newcastle BCA
NW-Preston BCA
NW-St Helens Copart
NW- Oldham IAA
NW - OTHER (see notes below)
NE-Northumberland IAA
NE-Peterlee Copart
NE-Teesside IAA
NE-Whitburn Copart
NE - OTHER (See notes below)
YS-Brighouse BCA
YS-Doncaster Church Lane IAA
YS-Doncaster Planet Road IAA
YS-Doncaster Wellsyke BML IAA
YS-Huddersfield Cooper Bridge IAA
YS-Leeds BCA
YS-Wakefield (Yorkshire) AB
YS-York – Copart
YS - OTHER (See notes below)
EM-Bury St Edmunds IAA
EM-Corby BCA
EM-Corby-(Baird-Road) BCA
EM-Corby Co Part
EM-Donington Park (East Midlands) AB
EM-Nottingham BCA
EM-Sandtoft IAA
EM-Thurleigh BCA
EM - OTHERS (See notes below)
WM-Birmingham-Perry-Barr BCA
WM-Measham BCA
WM-Prees Heath (Shropshire) AB
WM-Sandtoft Copart
WM-Stafford IAA
WM-Walsall BCA
WM-Wolverhampton BCA
WM-Wolverhampton Copart
WM - OTHER (See Notes below)
SE-Banbury IAA
SE-Bedford BCA
SE-Blackbushe BCA
SE-Crawley BCA
SE-Paddock-Wood BCA
SE-Sandwich Copart
SE-Southampton (Silverlake) IAA
SE - OTHER (See notes below)
SW-Bristol BCA
SW-Bristol Copart
SW-Bristol IAA
SW-Bridgwater BCA
SW-Gloucester Copart
SW-Gloucester IAA
SW-Newbury Copart
SW-Truro IAA
SW-Wellington Anchor Services IAA
SW-Westbury (Wiltshire), AB
SW-Westbury Copart
SW-Winsford IAA
SW - OTHER (see notes below)
LND-Chelmsford (Essex) AB
LND-Canvey Island IAA
LND-Enfield BCA
LND-Newark IAA
LND-Newbury IAA
LND-Peterborough IAA
LND-Warley - M25 IAA
LND - OTHER (See notes below)
AN-Colchester Copart
AN-Rochford Copart
AN-Sandy Copart
AN-Wishbech Copart
AN - OTHER (See notes below)
NI - Northern Ireland, ROI - Republic of Ireland, SC -Scotland, NW - North West, NE - North East, YS - Yorkshire, EM - East Midland, WM - West Midlands, LND - London, AN - Anglia, SE - South East, SW - South West
18
Preferred Collection Date* This field is required.
We can not always guarantee this date but will aim to work towards it. Collection will be made with 14days maximum
Month
Day
Year
19
Is this a CAT B vehicle (end of life vehicle)* This field is required.
yes
no
20
Has the vehicle been paid for* This field is required.
Yes
No
21
Are all storage charges paid for* This field is required.
Yes
No
N/A
22
Date storage Charges paid to
Date
Month
Day
Year
23
Does the vehicle start and Drive* This field is required.
Yes
No
24
Are there any other issues that will cause an issue for loading purposes (ie no handbrake etc) - please detail in notes section* This field is required.
Yes
No
25
NOTES
26
Copy of purchase invoice (please upload your purchase invoice here)
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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