HOME   Please provide your email address here:
1. TODAYS DATE:

2. DEALERSHIP NAME:
3. SENDERS NAME:
4. DEALER TELEPHONE NUMBER :
5. DEALER FAX NUMBER:
6. MAKE OF VEHICLE:
7. YEAR OF VEHICLE:
8. COLOR OF VEHICLE: if other type into "comment" box, thank you.
9. SHIPPING WEIGHT:
10. IS THIS VEHICLE A 2/DOOR OR 4/DOOR and or CONVERTIBLE? Can check multiple boxes: 2 DOOR or 4 DOOR or CONVERTIBLE
11. IS THIS VEHICLE A CAR OR A PICK UP TRUCK? CAR or PICK-UP TRUCK
12. IF THIS IS A PICK-UP TRUCK WHAT IS THE GROSS VEH. WEIGHT?

13.

IS THIS VEHICLE NEW WITH A CERTIFICATE OF ORIGIN? Yes or No
14. IF THE ANSWER TO 13 is NO WHAT STATE HAS THE VEHICLE BEEN TITLED IN?
15. IS THIS VEHICLE BEING PURCHASED BY AN INDIVIDUAL? Yes or No
16. WHAT IS THE CUSTOMERS DATE OF BIRTH?
17. IF THE ANSWER TO 15 IS NO, WHAT IS THE NAME OF THE LEASING COMPANY?
18. WHICH FLORIDA COUNTY DOES THE PURCHASER OR LESSEE RESIDE IN? CHECK FOR WHICH COUNTY
18 a. CITY?
19.

WHAT IS THE SALE PRICE OF THE VEHICLE? PLEASE FAX COPY OF BILL OF SALE TO:

407.654.2141 Thank You.
20. WHAT IS THE TRADE ALLOWANCE?
21. TAX PAID TO FLORIDA? Yes or No
22. IS THIS A FLORIDA TRANSFER? Yes or No
23. IF YES WHAT IS THE PLATE NUMBER?
24. IF A TRANSFER, WAS THE VEHICLE TRADED TO THIS DEALERSHIP? Yes or No
25. IS THERE A LIEN ON THIS VEHICLE? PLEASE PROVIDE LIEN HOLDER NAME AND ADDRESS IF APPLICABLE. Yes or No IF YES NAME AND ADDRESS OF OF LIENHOLDER:
26. WHAT IS THE DATE OF PURCHASE OR LEASE? _
27. THE STANDARD ISSUE PLATE IS A "SUNSHINE PLATE" If your customer prefers, speciality plates are available: CLICK TO VIEW SPECIALITY PLATES. COMMENTS or TYPE SPECIALTY PLATE CHOICE HERE.
28. PLEASE CHECK YOUR DATA, ON THE NEXT PAGE IF YOU NEED TO ADJUST FOR CORRECTIONS "CLICK YOUR BROWSER BACK BUTTON" TO RETURN TO THIS PAGE TO CORRECT THE ITEM.