Directions
Information About You
Name
Address
City
State Zip Code
For use in the USA Only
In most cases, manufacturer's restrictions preclude export of new vehicles,therefore we will only accept forms for vehicles to be delivered withinthe USA. Price will depend on vehicle availability and market conditions.
Contact Information
Day phone Evening phone
Best time to call
E-mail
Purchase Time Frame
ImmediateBuyer
- I plan to purchase within 48 hours to seven days
SeriousBuyer
- I plan to purchase within eight to fourteen days
Futurebuyer
- I plan to purchase within the next month or two
Purchase Information
I plan to
finance
lease
paycash
Down payment $
Requested Vehicle Information
Model Info
Year
Make
Model
Body Style
(ie. 2 door, 4 door, Station Wagon, Van...)
Options Requested on Vehicle:
For Trucks Only
Cab Type
NotApplicable
Regular Cab
SuperCab
Engine Size Requested (optional)
Axle Ratio Requested (optional)
Towing Package (requested)
Payload Package (requested)
Drive Train Info
Transmission
Automatic
Manual
Type of Drive
TwoWheel Drive
All Wheel Drive
FourWheel Drive
Engine Size
Color of Vehicle:
1
st
Choice Exterior Color
Exterior Color Accent or Secondary Color for Two Tone
Interior Color
Cloth
Leather
2
nd
Choice Exterior Color
Exterior Color Accent or Secondary Color for Two Tone
Interior Color
Cloth
Leather
Quote Request Notes, Questions or Comments:
Trade-in Information
Do You Plan on Trading in a Vehicle?
No
Yes- if Yes Please Complete the Following:
Year
Make
Model
Trim Level
Condition
Mileage
Trade-in Notes:
Jack Safro Lincoln Mercury
1000 East Summit Avenue
Oconomowoc, WI 53066
1-800-564-5574
e-mail :
lincmerc@safro.com
