Agriculture UEAF - Lloyd Ltd

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Sales Representative:
Tell us who is completing this form:
Branch:
Customer Details
Customer Name:
First Last
Address:
Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country
Account Number:
Mobile Number:
Home Phone:
Work Phone:
Personal Email:
Work Email:

Used Equipment Details
Make:
Model:
Description:
Serial Number:
Registration Number:
Warranty End Date:
Date Format: MM slash DD slash YYYY
Meter Hours:
Year of Manufacture:
Cab Type:
Suspension:
Transmission:
Specification
Group Code:
Machinery Sector:
AGRICULTURE
Check box where included:
- Air Con
- 2-Wheel Drive
- 4-Wheel Drive
- Spool Valves
- Push Back Hitch
- PTO - 1000
- PTO - 1000E
- PTO - 540
- PTO - 540E
Spool Valves:

Condition
Overall Condition:
Tyre Size (front):
Tyre Size (rear):
Tyre Condition (front):
Tyre Condition (rear):
Valuation
Type:
Cost Price:
Transfer/Trade Price:
Trade Bid Date:
Date Format: MM slash DD slash YYYY
Score:
Retail Price:
Trade Bid Value:
Trade Bid From:

Notes
Internal Description:
Internal Notes:
Central Admin
Date of Deal:
Date Format: MM slash DD slash YYYY
Gold Stock No.:
Sales Rep No.:
Sales Rep Name:
Phone
This field is for validation purposes and should be left unchanged.