Vehicle Details

Vehicle Make:

Vehicle Model:

Registration No:

Year of Manufacture:

Estimated Value:

Colour:

Road Tax Expiry Date:

MOT Expiry Date:

Please attach copy or original MOT Certificate.
PLUS copy or original registration document (V5C).

Will you require Carbank All Risk Storage Insurance:
Yes No
(NB this covers fire/accidental damage/loss whilst in our care). If no, we will require completion of Carbank insurance form to confirm cover is in place.

Name of Insurer:

Address:

Policy No:

Are you the owner of the vehicle:
Yes No

If No, please give the name and address of owner.

Name of Owner:

Address of Owner:

Is the vehicle subject to HP or finance:
Yes No

If Yes, please give the name and address of Finance Company.

Name of Finance Company:

Agreement No:

Collection Details

N.B. Driven collections/deliveries will not be undertaken without a current MOT test in force if applicable. Carbank must hold a copy on file prior to collection or delivery. Please leave minimum of half a tank of fuel for collection. Untaxed vehicles can only be delivered to a private address.

Collection Address:

If airport collection:
Airline:

Flight No:

ETD:

Terminal:

Instructions for Airport collections will be forwarded once the booking form is returned.