Classic Car Appraisal Form

Please provide the following contact information below. Answer all questions thoroughly while scrolling down. Please don't leave boxes blank.

First Name
Last Name
Middle Initial
Title
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
FAX
E-mail
URL

Enter today's date :

-- mm/dd/yy

Indicate that you have read the terms and conditions, and agree to have $75 debited from your credit card for a classic car appraisal based upon the information you provide in this form:

yes/no

Select any of the following options that apply:

Master Card
AMEX
VISA
Discover

Enter your name as it appears on your credit card in the space provided below.


Enter your credit card expiration date (00/00/00) in the space provided below.


Enter your credit card number in the space provided below.


Please provide the Year, Make, and Model of your Classic Car below:

Year & Make
Model
VIN Serial Number

Enter the general condition of your classic in the space provided below.


License Number & State


Enter the size and number of dents, dings, and scratches in the space provided below.


Enter your Odometer Reading in the space provided below.


Exterior Paint Color & Condition


Rust Location & Amount


Enter your Tire Size, Brand, & Treadwear in the space provided below.


Enter your Wheel Type & Make in the space provided below.


Enter your Dashboard Condition in the space provided below.


Enter your Interior Door Panel Condition in the space provided below.


Enter the Seat Condition & Quality in the space provided below.


Enter the Door Panel condition in the space provided below.


Enter the Headliner Condition in the space provided below.


Enter the Motor Size and Condition in the space provided below.


Enter the Transmission Condition in the space provided below.


Enter the Suspension Condition in the space provided below.


Enter the condition of Shocks in the space provided below.


Enter the condition of Steering in the space provided below.


Enter the condition of Brakes in the space provided below.


Enter the Heater condition in the space provided below.


Enter the condition of your Air Conditioning unit in the space provided below.


Enter your Radio/Stereo Make & Type in the space provided below.


Terms & Conditions

Please fill out all information requested above. Liability of the appraiser for damages stemming from this appraisal report is limited to the $100 fee paid by applicant. This appraisal is strictly the opinion of the appraiser and is made, offered, and rendered without recourse.

 

Affordable Classics Inc. Affordable Classics Inc. tel 503.653.4030 fax 503.653.1422