CASH PURCHASE

DeMaagd Nissan
333 W Dickman Road
Battle Creek, MI 49037
269-963-5538
demaagdnissan.com
In the event that you wish to purchase your vehicle from DeMaagd Nissan with cash payment, fill out this form to initiate the process.
BUYER Print
 
PERSONAL INFORMATION
Name Prefix: 
First Name: 
Middle Name: 
Last Name: 
Name Suffix: 
Email Address: 
Day-time Phone: 
Evening Phone: 
Mobile Phone: 
Work Phone: 
Birth Date (dd/mm/yyyy): 
Social Security#: 
 
CASH AMOUNT:
$: 
Source: 
 
ADDRESS INFORMATION
Home Address: 
Home City: 
Home State: 
Home Zip Code: 
 
COMMENTS:
VEHICLE INFORMATION
 
VEHICLE WANTED
StockID: 
VIN: 
Type: 
Year: 
Make: 
Model: 
Trim: 
Color: 
Budget Amount $: 
Buy Time Frame: 
 
TRADE-IN VEHICLE
VIN: 
Year: 
Make: 
Model: 
Trim: 
Miles: 
Color: 
Finance Company: 
Monthly Payment $: 
OPT-IN REQUIRED: 
 
By submitting this form to DeMaagd Nissan, 333 W Dickman Road, Battle Creek, MI 49037, 269-963-5538, you certify that the information provided is complete and accurate to the best of your knowledge; and you authorize us to use this information for purposes pertaining to this submission.
®© 2018 ROGEE