INFORMATION CARD


Name :
Street :
City :
State :
Postal Code :
Country :
Phone
Fax
E-mail
   
I wish to receive detailed information about :
 
Make :
Model :
 
Left hand drive
Right hand drive
 
Exterior 1.
color choice 2.
3.
   
Interior Cloth
choice Leather
 
 
Specifications Eurpean U.S. British
   
Optional equiptment
   
   
PLace of delivery
Shipside Holland
Direct Shipment
   
Direct Shipment to :
   
Type of legal liability only
insurance : legal liability and collision (incl. fire & theft)
  Marine insurance (Shipment only)
   
Length of insurance month(s) (driving only)