UPDATED 10-04-2008
SELLING? WERE BUYING! We purchase all makes, models and years. Call 800-257-9634 to find out the cash value of your vehicle.
PICKUP REQUESTED BY:
TODAY’S DATE
COMPANY NAME
ADJUSTER NAME
ADJUSTER PHONE #
CLAIM #
VEHICLE OR ITEM TO BE PICKED UP:
YEAR
MAKE
MODEL
COLOR
VIN #
ACV (IF APPLICABLE)
LOCATION OF VEHICLE OR ITEM
ADDRESS
CITY AND STATE
ZIP CODE
LOCATION PHONE #
DATE AVAILABLE TO PICK-UP
INSURED OR CUSTOMERS NAME
OWNERS NAME
CONTACT PERSON
IS VEHICLE DRIVEABLE?
IS VEHICLE TOWABLE?
WHERE ARE KEYS LOCATED?
SETTLED ?
CHARGES TO BE PAID?
SPECIAL INSTRUCTIONS
FOR SALE 2008 Cherokee Graywolf Camper Bumper style hitch - Call 712-470-3061 for details
Hours of Operation - Monday-Friday - 7:30-5:00 Saturday - 7:30-12:00
LEMS AUTO RECYCLERS ~ 402 GERE AVE.~DOON, IA~51235 1-800-257-9634 OR 712-726-3202
www.lemsauto.com E-mail - search@lemsauto.com
NOT RESPONSIBLE FOR TYPOGRAPHICAL ERRORS
