Trade In Form

Please take a moment to fill out the information about the vehicle you are planning on trading in. We will get to you shortly in order to offer you the best possible quote. Thank you.

For additional information, call us at (800) 756-3097 and ask for Bob DePerry.

Vehicle Information

* Year:
* Make:
* Model:
Trim:
Body Style:
VIN:
Odometer:
Transmission:
Exterior Color:
Interior Color:
Current Monthly:
Payoff Balance:
Estimated Value:

Installed Options

ABS Brakes
Air Conditioning
AM/FM Stereo
Cassette
Single CD
Multi CD
Integrated Cellular
Navigation System
Cruise Control
4 Wheel Drive
Leather
Power Locks
Power Windows
Power Seats
Tilt Wheel
Rear Air/Heat
Air Bag
Dual Air Bags
Alloy Wheels
Premium Wheels
Wheel Covers
Luggage Rack
Sun Roof
Moon Roof
Anti-theft
Video System
DVD System
Privacy Glass
Bra
Running Boards
Third Seat
Towing Package
Bed Liner
Short Bed
Long Bed
Sliding Rear Window
Dual Rear Wheels
Custom1
Custom2
Custom3
Custom4

Contact Information

* First Name: * Last Name:
* Email: Home Phone:
* Day Phone: Fax:
Cell Phone: * Preferred Contact:
Address:
City: State: * ZIP Code:

Additional Vehicle Information

Title History:
Emissions:
Odometer Reading:
Registration:
Service Maintenance:
Service Records:
Body Repair Done:
Additional Information:

Vehicle Condition

Please rate the overall condition of your vehicle. "Excellent" indicates that your vehicle is in excellent mechanical condition, has glossy paint and a perfect interior. "Good" indicates that your vehicle is free of any major defects and has only minor visual blemishes. "Fair" indicates that the vehicle has some mechanical or cosmetic defects but is in safe running condition. "Poor" indicates that the vehicle has severe mechanical and/or cosmetic defects.

Overall Condition: Excellent Good Fair Poor

Exterior Condition

Please rate the exterior condition of your vehicle.

Body: Excellent Good Fair Poor
Paint: Excellent Good Fair Poor
Glass: Excellent Good Fair Poor
Rust: Excellent Good Fair Poor
Lights/Lenses: Excellent Good Fair Poor
Comments:

Interior Condition

Please rate the interior condition of your vehicle.

Carpet: Excellent Good Fair Poor
Upholstery: Excellent Good Fair Poor
Heating & A/C: Excellent Good Fair Poor
Power Accessories/Instruments: Excellent Good Fair Poor
Comments:

Mechanical Condition

Please rate the mechanical condition of your vehicle.

Engine: Excellent Good Fair Poor
Transmission: Excellent Good Fair Poor
Suspension: Excellent Good Fair Poor
Steering: Excellent Good Fair Poor
Brakes: Excellent Good Fair Poor
Tires: Excellent Good Fair Poor
Comments:
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Falvey's Motors
395 West Thames Street
Norwich, CT 06360
Site Map
Email: Contact Us
Sales : (800) 756-3097
Service:: (800) 559-5667