Customer Purchase Form

Welcome to the D. M. Keith customer purchase form. We’d like to thank you once again for your business. This is a secure form in which you can submit your details of your part exchange that will allow us to formally purchase your existing vehicle from you. Please take the time to watch the video and carefully fill in and digitally sign the form below.

       D. M. KEITH RETAILER

    Please choose your D. M. Keith retailer:

       PERSONAL DETAILS

    First Name:

    Last Name:

    Your Email:

    Please enter your your postcode to look up your address:

       VEHICLE DETAILS

    Vehicle Make:

    Vehicle Model:

    Vehicle registration mark:

    Vehicle registration date:

    Vehicle colour:

    Current Exact Vehicle Mileage:

       VEHICLE GALLERY - IMPORTANT

    MANDATORY VEHICLE PHOTOS, it is important that you please upload photos of the following photos: Photo of page 2 of V5:

    Photo of page 3 of V5:

    Photo of both keys:

    Photo of mileage:

       VEHICLE GALLERY

    VEHICLE PHOTOS, please upload a photo of all sides of the vehicle. Front of vehicle:

    Rear of vehicle:

    Side 1 of vehicle:

    Side 2 of vehicle:

       I CERTIFY & WARRANT THAT

    1) I agree to sell the above vehicle. 2) The vehicle is not the subject of any hire purchase agreement, lien or other Encumbrance, except (if applicable) the Finance Settlement detailed above

    Name of of company for finance settlement -

    3) The vehicle

    purchased by me new

    4) The vehicle shown above

    accurate .

    5) The Vehicle

    been used for hackney carriage, taxi, or courier work, or as a police or driving instruction vehicle.

    6) The Vehicle

    been fully serviced and in accordance with the manufacturers recommedation at an approved manufacturer facility. I produce a service book to authenticate this.

    7) The Vehicle

    sustained any serious damage or been categorised as a total loss.

    8) The vehicle

    have a valid MOT.

    9) A current registration document

    been uploaded with this document above.

    10) The Vehicle has had

    owners including me.

    11) I

    registered for VAT.

    12) What faults of the vehicle are you aware of?

       DATA PROTECTION STATEMENT

    I declare that the information given above is correct and I have read, understood and agree to be bound by the terms and conditions. Input Tax Deduction has not been and will not be claimed by me in respect of the goods sold on this vehicle. This document contains the terms of a contract. Sign it only if you wish to be legally bound by them. Attention is drawn to the terms and conditions and in particular to clauses which relate to acceptance of any Part Exchange Vehicle.

       PLEASE SIGN & SUBMIT