Customer Name:
Other people involved in making a final decision about this vehicle?
yesno
Company Name:
Address:
Suburb:
Drivers Lic. No:
Phone (BH):
Phone (AH):
Mobile Phone:
Email:
Email (Alternative):
Please locate the following vehicle:
Make:
Model:
Build Year:
Body type:
Distance travelled (KM):
Please don’t exceed ($):
My trade in details:
Known faults are:
I have read and agree to the terms of this purchase agreement
I do not agreeI agree
Date
