1166 Blanding Blvd.

Orange, Park, FL 32065



Customer Information

Vehicle Information

Trade-In Information

Pricing Information

Plus tax, title, registration, trade payoff, if applicable and Pre-Delivery Service Charge of $499*

Please Sign On The Line Below

By signing this authorization form, you certify that the above personal information is correct and accurate, and authorize the release of credit and employment information. By signing above, I provide to the dealership and its affiliates consent to communicate with me about my vehicle or any future vehicles using electronic, verbal and written communications including, but not limited to, eMail, text messaging, SMS, phone calls and direct mail. Terms and Conditions subject to credit approval. For Information Only. This is not an offer or contract for sale.

*Pre-Delivery Service Charge. These charges represent costs and profit to the dealer for items such as inspecting, cleaning, and adjusting vehicles, and preparing documents related to the sale.

This form identifies your interest in the vehicle detailed above. All vehicles subject to prior sale. Upon receipt of this form, a dealership representative will contact you to confirm vehicle availability. Upon confirmation of availability, after receipt of a $500 deposit, vehicle will be held for 48-hours to provide time to complete the vehicle purchase.

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