IMLACHS ELV Recyclers - Car Removals Service 7 Days Ph 1300 652 070 $$$ Paid LMCT 1229







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Removal Request Form

To make an on-line booking to have your vehicle removed, simply fill in the following form, and click on the [send] button. You will automatically receive a confirmation email on the address you give on the form.

All mandatory fields have bold titles. Booking Assistance Ph 1300 652 070

PLEASE NOTE - A confirmation telephone call will be made to you, prior to any vehicle collection.

	OWNER DETAILS
Name
Address		Full address, including postcode
Contact Phone	The best daytime phone to contact you
Alt Phone	An alternative contact number
Email Address	A confirmation email will be sent to this address
Relationship	Select your relationship to the vehicle
Drivers Licence	Enter Owners Drive Licence Number
	VEHICLE DETAILS
Make
Model / Year
Colour
Body Style
Registration Type	Select the status of your registration
Registration No.
Additional Characteristics		Other special characteristics of vehicle
	COLLECTION DETAILS
Pick Up Location		Address if different from owner's
Where	Select the vehicle's location
Collection Day
Collection Date	Specify your preferred collection date 99/99/99
Collection time	Select your preferred time of day
Keys / Papers	Select where you will leave the keys and papers
Special Instructions
Price Offer	Please select the price for your car
	To help us provide better service, please let us know how you found this website.
How you found us
	DECLARATION I am authorised to dispose of this vehicle, and hereby guarantee that is is not stolen, and that it is free from all debts
Acceptance

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Home | Our Service | Collection Request | Contact Us | Links

www.imlachs.com.au | www.autowreckers.com.au | www.elv.com.au

Licensed Motor Car Trader 1229

Licensed Second-hand Dealer 12871

Insured

Refrigerant Trading Authorisation AU02384