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Inspected by: Niels Wormsbecher

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Brand:
Model:
Model year:
Model type:
License plate:
Report code:
Chassis number:
Type of vehicle:
First int. reg.:
First NL reg.:
Color:
Weight (kg)(kg):
Empty weight(kg):
Wheelbase (cm)(cm):
Top speed (km/h):
Cons. in the city (l/100 km):
Cons. outside the city (l/100 km):
Avarage consumption (l/100 km):
Acceleration (s):
Cargo space (l):
Permissible max weight (kg):
Loading space length (cm):
Loading space width (cm):
Loading space height (cm):
Hydraulic Installation:
Mileage(km):
Number of doors:
Vehicle length (cm):
Vehicle width (cm):
Vehicle height (cm):
Vehicle body type:
Traction:
Power(kw):
Transmission:
Number of gears:
Displacement(cc):
Number of cylinders:
Fuel type:
Fuel tank capacity:
EU category:
Energy label:
NL Tax Rate %:
CO2(g/km):
Nb. of Axles:
APK date:
Trailer Weight (kg):
Towing Capacity (kg):
Load capacity (kg):

opties

 

NAVIGATION

Additional information

 

Number of keys:

Interior color:

Upholstery:

Number of seats:

Number of headrests:

Maintenance booklet:

Stamp date:

Last turn mileage(km):

Distributieriem vervangen:

KM:
Datum:
Distributieriem vervangen

Tires

 

Damages

Not acceptable

Optical damage

€

Technical damage

€

Interior damage

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Remarks

 
Origin: Leasemaatschappij
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Tire position
Tire type
Wheel type
Tire size
Tire brand
Tire profile depth
Car damage
Body part:
Type of damage:
Suggested repair:
Car damage
Type of damage:
Suggested repair:
Car damage
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Car damage
Type of damage:
Suggested repair:

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CLAIMED FIELD DISPLAY NAME

Claimed value €:

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Damaged seat
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Car image
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