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First & Last Name:
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A value is required.Invalid format. |
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Street Address |
A value is required.Invalid format. |
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City |
A value is required.Invalid format.
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Province |
Only BC pickup is possible.
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Postal Code |
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Cell Phone |
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Day Phone |
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Email address: |
A value is required.Invalid format. |
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Make |
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Model |
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Year |
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Kilometres |
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VIN |
 VIN = Vehicle Identification Number.
If this data is not available now,
submit form and we will collect it on pickup
This information can be found on your Registration papers.
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License Plate Number
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(If Availible)
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Title Information |
A value is required.
 Do you have the Registration Papers?
What are the name(s) written on title?
Any liens on title?
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Registration |
Registration up to date?
Last year paid?
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Running Condition
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Running Condition Description |
When last running well?
Known problems
or observed problems.
Any estimates of repair cost.
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Exterior Condition |
Paint, rust, dents, broken parts.
DAMAGE: part(s) damaged / extent of damage(s) |
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Interior Condition |
Upholstery, carpets, instrument panel, a/c working etc.
Describe damage or non functioning parts. |
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Location of Vehicle |
If location is different than the above address please
provide street address,
City
Also name and phone number
of contact if available. |
Special instructions or Comments.
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We will process your form and contact you as soon as possible.
