Classic Car Agreed Value Declaration Form

01376 574000
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Classic Car Agreed Value Declaration Form

To agree the value of your vehicle, the Company require this form completed in full together with six recent photographs of your vehicle clearly showing both sides, front, rear, interior and engine bay. Please ensure the registration number is visible in at least one photo.

Name:

Email:

Postcode:

Vehicle Make:

Vehicle Model:

Engine Size :

Reg Number:

Year Of Make:

Garage/Drive/Road:

Date Of Purchase:

Purchase Price:

Requested Value:

Condition Report

Body1234

Interior1234

Electrics1234

Engine/Trans1234

Chassis/Floor1234

Tyres1234

KEY: 1 = EXCELLENT 2 = GOOD 3 = AVERAGE 4 = POOR

Has Or Will The Vehicle Be Modified From The Maker’s Standard Specification ?
YesNo

If ‘YES’ please give details of any non-original fittings, repairs or other special features :

Restoration details (if applicable) :

DECLARATION: I/We declare that the above statements and particulars are true and complete to the best of my/our knowledge and belief and that I/we have not withheld any material facts. Material facts are those facts that the Company would regard as likely to influence the acceptance and assessment of the valuation.

If you are in any doubt as to whether or not information is material, it should be disclosed.

Attach Document :

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Please Note:

  • Only add one image at a time – click ‘Add More Documents’ to send multiple files
  • Accepted file formats: doc, docx, pdf,jpg and png
  • Total combined file sizes must not exceed 30MB
  • Please do not send more than six photos