■ Customer information
NAME
ADDRESS
TEL
FAX
E-MAIL
Reporting method
TEL  FAX  E-Mail
■ Vehicle information
Year
Maker
Grade
Displacement
cc
Body Color
Serial No.
Mileage
Vehicle inspection
year mounth
Transmission AT  MT
Number of doors
2Door 3Door  4Door  5Door  Other
Drive Term
4WD 2WD
Fuel
Gasoline Light oil
Registration
New car registration Used car registration
Balance of loan purchase
No  Yes
Appeal point
& coment, etc.
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