First Name*
Last Name*
Odometer Reading (KM)*
Has this vehicle ever been registered outside of British Columbia? Yes No
Has this vehicle ever been in an accident? Yes No
Over $2,000? Yes No
How Much?
Accident Description
Is this vehicle an Ex-Rental? Yes No
Is this vehicle an Ex-Lease? Yes No
 Air Conditioning Leather Heated Seats Power Seats Sunroof/Moonroof CD Player DVD Player Power Door Locks/ with Keyfob Power Windows Power Mirrors Cruise Control USB Port Alloy Wheels Nav System Snow Tires
Do the above items work properly? Yes No
Please list what does not work below
Do you follow factory recommended maintenance? Yes No
Do you have copies of service invoices? Yes No
Do you know when the tires were replaced? Yes No
Would you recommend this vehicle to a friend or family member? Yes No
What repairs or maintenance would you complete before selling this vehicle to a friend or family member?
Please include as many clear photos as you can, one for each of the 4 corners, both side views, the interior front and back, the VIN number and registration. If there is any dents, damage or rust, please include close up photos for our review.
Exterior Photos
Interior Photos
Other than what has been disclosed herein, I declare that my trade-in does not have any mechanical defects and that it has not sustained any accident or physical damage, nor was such information disclosed to me when I purchased or leased it. Yes No
Would you like to schedule an appointment? Yes No
Customer Signature*
This will be accepted as your electronic signature.
By submitting this form you agree to be contacted by a Spring Honda staff member.