J&J MARKETING SOLUTIONS, INC. 7801 S. ROBERTS RD. BRIDGEVIEW IL

TEL: 708-458-8344 www.best4wheels.com EMAIL: INFO@BEST4WHEELS.COM

VEHICLE INSPECTION AND PUBLISHING REQUEST:

TITLE CERTIFICATES MUST BE IN THE NAME OF PERSON APPLYING BELOW.

MAKE: _____________________ MODEL:___________________

YEAR: ________ VIN: ___________________________________

# OF KEYS ___ FACTORY WARRANTY ___

BOOKS ___ MILEAGE _______________

OWNER(S) & ADDRESS:

___________________

___________________

___________________ LIEN HOLDER: (If Any): _______________________

PHONE: ________________

PRICE REQUESTED: ___________

PRICE QUOTED ___________

TYPE OF AD (CIRCLE ONE):

FULL SERVICE FEE: $300.00 plus 3%(if sold) AD/RESEARCH ONLY: $200.00

SIGNED: _____________________ DATE:_________

________________________________________________________

OFFICE USE ONLY

CONDITION REPORT Y/N

MECHANICAL/COSMETIC/TITLE HISTORY

PRICE QUOTED: ____________

DATE LISTED: __________ /PHOTOS:_____

HOSTED: Y/N DATE RECEIVED:_________