Mini Van Appraisal Request & Vehicle Questionnaire Please enable JavaScript in your browser to complete this form.Full Name or Company Name *Email *Phone Number *Zip Code *Vehicle Make *Model *Mileage *Year *VIN *Name of the Conversion Company (VMI, Braun, FR etc.)* (indicate usure if necessary) Trim Level (SXT, Touring, Limited, etc.) Conversion & Adaptive Equipment: Please check all that Apply. Rear Entry Lowered FloorSide Entry Lowered FloorEntrance Height under the ramp door minimum of 55” on a side entry minimum of 54” on a rear entryPower RampPower LiftKneel System (the back corner comes down as the ramp lowers to create a lower ramp angle)Hard Rubber FloorSteps Flares Outside Front Driver and Passenger DoorThe van has a Removable Drivers Seat or a Transfer Seat has been installed in the front driver position.Removable Passenger SeatSelf-Driving or Added Equipment, Describe BelowDescribe Self-Driving and/or Added Equipment if checked aboveYou will be sent an appraisal which indicates either the Buyer's Pricing or the Seller's Pricing. Both a Buyer's Appraisal and Seller's Appriasal for the same vehicle is $29.95. Indicate the Appraisal(s) you would like:Buyer’s Appraisal showing Retail and Private Party Appraisals.Seller’s Appraisal showing Wholesale, Trade In and Private Party.Both Buyer’s and Seller’s Appraisal for the same vehicle is $29.95.Add'l Appraisal within 30 Days – Enter Reference #'s from earlier AppraisalsConsider the following (see below). On a Scale of 1-10 (10 being highest), please rate the vehicles conditionConsider the Items Below:Submit