CASH PURCHASE
DeMaagd Nissan
333 W Dickman Road
Battle Creek, MI 49037
269-963-5538
demaagdnissan.businessadvantagedealer.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
PERSONAL INFORMATION
Name Prefix:
Dr.
Miss.
Mr.
Mrs.
Ms.
Prof.
First Name:
Middle Name:
Last Name:
Name Suffix:
I
II
III
IV
V
Jr.
Sr.
Email Address:
Day-time Phone:
Evening Phone:
Mobile Phone:
Work Phone:
Birth Date (dd/mm/yyyy):
Social Security#:
CASH AMOUNT:
$:
Source:
Checking Account
Savings Account
Credit Card
Inheritance
Business
Dividend
Stock
Gift
Other
ADDRESS INFORMATION
Home Address:
Home City:
Home State:
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Home Zip Code:
COMMENTS:
VEHICLE INFORMATION
VEHICLE WANTED
StockID:
VIN:
Type:
New
Used
Year:
Make:
Model:
Trim:
Color:
Budget Amount $:
Up to $10,000
Up to $15,000
Up to $20,000
Up to $25,000
Up to $30,000
Up to $40,000
Up to $50,000
Up to $75,000
Up to $99,000
Up to $150,000
Up to $200,000
Up to $300,000
Up to $500,000
Up to $750,000
Up to 1 Million
Buy Time Frame:
Buy Immediately
Buy in 1 Week
Buy in 2 Weeks
Buy in 4 Weeks
Buy in 6 Weeks
Buy in 8 Weeks
Buy in 10 Weeks
Buy in 12 Weeks
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.
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