CLIENT INTERVIEW

The information requested below will be needed to complete the dealer paperwork & vehicle registration and help us keep in touch. This information will remain private. We will not share your information with anyone except to the extent necessary to complete the purchase of your vehicle. For your protection and privacy, until we have set up the proper security protections on our website, we do not ask you to provide your driver’s license number or social security number on this form, although this information (in addition to the information regarding your automobile insurance policy) is required by every state by law when purchasing a motor vehicle. Instead, we will contact you by phone to obtain this sensitive information and your credit card information. Or you can hire us by mailing a check made out to Consumers Automotive, LLC at the following address: 4915 St. Elmo Ave, Suite 200, Bethesda, MD 20814 and including your SSN and driver’s license number, state of issue, and expiration date.

Name (We need your name as it appears on your Drivers License or, if being registered in the name of a business, the legal name of that company)
Owner Name*
Co-owner Name
Address (we need the address where the car will be registered)
Street Address*
City*
State*
Zip Code*
Phone Numbers (we don’t have to have every number; however, if we can’t reach you quickly a great deal on your dream car may disappear)
Owner Office Phone
Owner Office Fax
Owner Home Phone
Owner Cell Phone
Co-owner Office Phone
Co-owner Office Fax
Co-owner Home Phone
Co-owner Home Fax
Co-owner Cell Phone
E-mail
Owner's E-mail*
Co-owner's E-mail
Birth Date
Owner's DOB*
     
Co-owner's DOB
     
Auto Insurance Information
Insurance Company
Policy Number
Effective Dates (start and end dates)
Agent's Name
Agent's Street Address
Agent's City
Agent's State
Agent's Zip Code
Agent's Phone (xxx-xxx-xxxx)

CERTIFICATION OF INFORMATION

By checking this box, I certify that the above information is true and complete to the best of my knowledge.

Please agree before continuing*