Disclosure Form

*VIN Vehicle Identification Number (V.I.N) You can typically find your VIN in these locations: Driver's side doorjamb, Windshield (lower, driver's side corner), or on Vehicle documentation (registration, insurance policy, lease, etc.)

*Accident Brand Located on your vehicle ownership/registration. If a vehicle has been damaged by collision, impact, fire or flood, or has been stolen and dismantled, it may have a “brand” applied to vehicle records that identify the extent of the damage

None/Active Salvage Rebuilt Irreparable

*Vehicle Information

* Drivers License #

General Information

*Registration Viewed Do you have possession of the vehicle ownership?

Yes No

*VIN Checked The VIN on the ownership matches the VIN on the driver's side doorjamb as well as the Windshield (lower, driver's side corner).

Yes No

*Original Manufacturer VIN Does the vehicle have the VIN from the manufacturer.

Yes No

*Has the vehicle ever been declared a total loss by an Insurer?

Yes No

*Has this vehicle been stolen and retrieved?

Yes No

*Does this vehicle run?

Yes No

*Does this vehicle have a Catalytic converter?

Yes No

*Is the vehicle missing the engine?

Yes No

*Does the vehicle have hail damage?

Yes No

*Does the vehicle have rust holes?

Yes No

*Does this vehicle have frame damage?

Yes No

Within the last seven years has this vehicle been registered in:

*Other Canadian provinces?

Yes No

*Registered in the U.S?

Yes No

If yes, identify Province(s) and/or State(s)

*Is Odometer faulty, broken, replaced, or rolled back?

Yes No

ODOMETER

* Exact # at time of Appraisal

KM MILES

Has this Vehicle been:

*Daily Rental Has this vehicle been involved in rental or carsharing? I.e. – Taxi, Limo, or Transportation app.

Yes No

*Fire Damaged

Yes No

*Immersed in water

Yes No

*Had any body panels painted or replaced?

Yes No

*Emergency Service vehicle

Yes No

*Anti-lock brakes inoperable Is the brake system working properly? ABS light on dashboard.

Yes No

Any previous repairs exceeding $3,000? If yes, explain - Describe anything major about the condition of the car. I.e- Engine or transmission failures, frame or sub frame problems, hail damage, or rust with holes.

Yes No

If yes, explain - Describe anything major about the condition of the car. I.e- Engine or transmission failures, frame or sub frame problems, hail damage, or rust with holes.

Sale Price: $ CAD

Disclosure Form

*Vehicle Information

General Information

Within the last seven years has this vehicle been registered in:

ODOMETER

Has this Vehicle been:

Bill Of Sale

*Seller Information

*Vehicle Information

*Buyer Information

Special Conditions of Sale/ General information