Part Exchange Evaluation

We are happy to evaluate cars up to 5 years old for part exchange. Please complete ALL the information in the box below

1. Which car are you interested in leasing or buying from broombroom? Volkswagen Golf ref: 1289

2. Contact Details
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Name:
Email:
Phone:
Town:

3. Part Exchange Car Details
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VEHICLE DETAILS
Vehicle Make:	 	 	 	 
Vehicle Model:
Specification:	 	 	
Registration Number:	
Date First Registered:
Number of previous owners:	 	 	 	 	
Imported?	 	 
Number Of Doors:	 	 	
Number Of Owners:	 	 
Engine Size:	 	 	
Current Mileage:	 	 
Average Monthly Mileage:	 	 	 
Colour:	 	 	
Is Colour Metallic?	 	 	 
Interior Colour:	 	 	
Is Interior: Cloth, leather or other?	 	  	 
Gearbox: manual or auto?		 	 	
Number Of Gears:	 	 
Engine Type: petrol, or diesel or other (please specify)? 	 
Body Style:	Hatchback, Saloon, Estate, Coupe, Convertible?	 	 	 	 
Does the car have?	Air-Con?	 	Sat-Nav?	 	 	Alloy Wheels?	 	CD Player?	 	  	 	 
Any Non-Standard options/Extras? (Please list)	 	  
Service History: Full, Part, None?	 	  	 	 
Serviced by:	Main Dealer:	 	Other (please specify):	 	  	 
MOT Expiry Date:	 	 	 	
Tax Expiry Date:
Do you have the V5 reg doc?	 	  
 
FINANCE DETAILS
Is there any outstanding finance on the vehicle?	 	 	 
What is your current settlement amount?	 	 	
Valid until/Next payment due?	 	 
Finance company name?	 	 	Telephone number?	 
 	 	 
CONDITION DESCRIPTION 
Please detail any damage giving description of size and nature of damage.
(E.g. 5cm scratch on driver’s door, too deep to polish out.)
Alloys (please check and detail any marks on all 4 wheels)
Front Bumper/Lights/Bonnet:	
Interior:
Windscreen/Roof/Rear Screen:	
Rear Lights/Tailgate/Rear Bumper:
Passenger Side:			
Drivers Side:
Does the car have any starting/running problems?		 
Any gearbox/clutch problems?		 	 
Are there any warning lights lit on the dashboard?	 
Any other information that may affect the value of the vehicle?

VALUE
Ideal date you would like to swap your car:
Value you are expecting for the car: £
Any additional comments:		 
 
DECLARATION
In returning this form to obtain a valuation I declare that:
* The information given above is true to the best of my knowledge.
* The vehicle has not been the subject of an insurance write off.
* The vehicle has not been used as a Hackney Carriage or as a Private Hire or Driver Instructor vehicle.
* There is no other information that might affect the value of the vehicle, which I have omitted.
* I understand that you reserve the right to charge me for the cost of rectifying any damage to the vehicle not disclosed above.

I hereby confirm I am the registered owner of the car and the above details are both accurate and complete. I understand that any valuation or offer to purchase is based on the accuracy of this information. Should the car differ in any form to the information given, I understand you reserve the right to not accept the car as a part exchange or adjust the valuation accordingly.

Please leave this blank (a non-human trap):

0207 193 1737

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