Kidston - Insurance

YOUR DETAILS

FIRST NAME *

LAST NAME *

E-MAIL *

FAX *

ADDRESS *

Please select as appropriate *

THE MOTOR CAR

MAKE *

YEAR *

CHASSIS NUMBER *

ENGINE NUMBER *

Is the engine original to this chassis? *

Yes No

ENGINE CAPACITY *

AVAILABLE OWNERSHIP DOCUMENTS (PLEASE LIST)

MODEL *

REGISTRATION *

MILEAGE/KILOMETRES *

Left or right hand drive *

EXTERIOR COLOR *

INTERIOR COLOR *

Are the colors original to this car? *

Yes No

PLEASE LIST ANY FACTORY OPTIONS FITTED TO
THE CAR

PLEASE LIST ANY KNOWN DEFECTS

PLEASE LIST ANY POST-FACTORY MODIFICATIONS

PLEASE LIST ANY RACING HISTORY

PLEASE LIST OWNERSHIP (IF KNOWN)

DOES THE CAR HAVE ALL FACTORY
OWNERS AND SERVICE MANUAL? *

DOES THE CAR HAVE ITS FACTORY TOOLKIT? *

HAS THE CAR SUSTAINED ANY ACCIDENTS?
IF YES, PLEASE GIVE DETAILS *

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I understand and agree the following conditions *:

Please provide me with a current market valuation, assuming a willing buyer and a willing seller.
I understand that this valuation will be provided by Kidston SA without guarantee and does not constitute a purchase offer.

* essential fields

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Company Presentation

Catalogues

Private Treaty Spring - Summer 2012

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