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Motorcycle Appraisal Request Form

First Name:
Last Name:
Street Address:
 
City:
State:
Nearest Major City:
Zip Code:
Email:
Telephone Number:
Fax Number:

Location and Owner of Motorcycle (if different from above)
Same as above:
First Name:
Last Name:
Street Address:
 
City:
State:
Nearest Major City:
Zip Code:
Email:
Telephone:
Fax Number:
Purpose of Appraisal:

Additional Comments or Special Instructions

Motorcycle Information
Motorcycle Year:
Motorcycle Make:
Motorcycle Model:
Motorcycle VIN:
Motorcycle Number:

 

You may print the form and fax/mail to:

Polk Associates, LLC
PO Box 720
Ojai, CA 93024
Ph: 805.646.7293
Fax: 805.646.7294