| Your Contact Information |
| * Applicant's Name: |
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| * Address: |
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| * City: |
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| * State: |
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| * Zip: |
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| * Home Phone: |
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| * Business Phone: |
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| * Fax: |
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| * Email: |
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| * Preferred Method of Response: |
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| * Best Time to Contact: |
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| Appraisal |
| * Year: |
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| * Manufacturer: |
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| * Make: |
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| * Model: |
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| * What is the condition: |
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| * What do you think its value is? |
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| Please check all that apply: |
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| AIR CONDITIONING AND HEATING |
| 11,000 BTU |
7,000 BTU |
| 13,500 BTU (Non-Central/Non-Ducted) |
Aqua Hot Heating System |
| 13,500 BTU Central/Ducted |
Furnace (10,000-12,000 BTU) |
| 15,000 BTU (Non-Central/Non-Ducted) |
Furnace (13,000-17,000 BTU) |
| 15,000 BTU Central/Ducted |
Furnace (21,000-28,000 BTU) |
| 15,000 IPO 13,500 |
Furnace (30,000-35,000 BTU) |
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| APPLIANCES |
| Central Vacuum Cleaner |
Refrig. 4dr w/Ice Maker (Luxury only) |
| Dishwasher |
Refrigerator Side By Side Upgrade |
| Dryer |
Washer/Dryer Combo |
| Garbage Disposal |
Washing Machine |
| Gas Grill Cook Top |
Water Heater 10 Gallon Gas/Elec. |
| Ice Maker (Stand Alone Unit) |
Water Heater 10 Gallon Gas/Elec. w/DSI |
| Microwave Oven |
Water Heater 6 Gallon Gas/Elec. |
| Microwave/Convection Combo |
Water Heater 6 Gallon Gas/Elec. w/DSI |
| Microwave/Hood Combo |
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| ENGINE AND SUSPENSION SYSTEMS |
| Air Assisted Suspension |
Steering Stabilizer |
| Exhaust Brake |
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| ENTERTAINMENT |
| AM/FM Cassette Stereo |
T.V. 10" Color |
| AM/FM/CD Stereo |
T.V. 13" Color |
| CD Player (Multiple) |
T.V. 19" Color |
| DVD Player |
T.V. 27" Color |
| Satellite System - In Motion |
T.V. 42" Plasma 9 |
| Satellite System W/Auto Seek |
T.V. Antenna W/Booster |
| Satellite System W/Manual Point |
VCR/VCP |
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| GENERATORS |
| 2 - 3 KW Gas |
6 - 8 KW Diesel |
| 4 KW Gas |
6 KW Gas |
| 5 KW Gas |
7 - 8 KW Gas |
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| JACKS AND LEVELING SYSTEMS |
| Air Leveling System |
Hydraulic/Air Dual Leveling System |
| Hydraulic Leveling System (Automatic) |
Scissor Stabilizer Jacks (Each) |
| Hydraulic Leveling System (Manual) |
Stabilizer Jacks-Crank Down (Each) |
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| MISCELLANEOUS OPTIONAL EQUIPMENT |
| 6 Way Power Seat (Each) |
Power Cord Reel |
| 8 Way Power Seat (Each) |
Power Roof Vent |
| Aluminum RV Wheels (Set of 4) |
Power Roof Vent W/Rain Sensor |
| Auxiliary Battery (Each) |
Power Slide-Out Room (Bedroom) (Each) |
| Awning - Electric(Each) |
Power Slide-Out Room 14' (Each) |
| Awning 10' - 12' (Each) |
Power Slide-Out Room 16' (Each) |
| Awning 13' - 14' (Each) |
Power Slide-Out Room 6' (Each) |
| Awning 15' - 16' (Each) |
Power Slide-Out Room 8' (Each) |
| Awning 17' - 19' (Each) |
Rear Vision Camera/Monitor |
| Awning 20' - 22' (Each) |
Safe |
| Awning 23' - 24' (Each) |
Security System (Basic) |
| Awning 25' (Each) |
Security System (Deluxe) |
| Awning for Slide-out (Bedroom) |
Shower Enclosure (Glass) |
| Awning for Slide-out (Coach) |
Skylight |
| Cabinetry Upgrade (Luxury) |
Slide Out Tray-Full Pass Through |
| CB Radio |
Slide Out Tray-One Side |
| Ceiling Fan |
Solar Battery Charger |
| Cruise Control |
Solar Panel (Each) |
| Driver Side Door |
Spare Tire and Carrier |
| Driver Side Door W/ Power Window |
Spot Light (Remote) |
| Electric Step (Double) |
Storm Windows (All) |
| Electric Step (Single) |
Tile Upgrade (Bathroom/Kitchen) |
| Fiberglass Exterior 30' and Under |
Tilt Wheel |
| Fiberglass Exterior 31' and Over |
Trailer Hitch |
| GPS Navigation System |
Two Wheel Car Tow |
| Inverter (1000 Watt) |
Water Purifier W/Dispenser |
| Inverter (2000 Watt) |
Window Awning 3' (Each) |
| Inverter (600 Watt) |
Window Awning 4' (Each) |
| LPG Gas/Smoke Detector |
Window Awning 5' (Each) |
| Luggage Rack and Ladder |
Window Awning 6' (Each) |
| Mirrors (Power W/Defrost) |
Window Awning 7' (Each) |
| Outside Shower |
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| Commments or Questions: |
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| * These fields are required |
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