Trailer Appraisal Request

Name: ________________________ VIN#: _________________________

Make: ________________________ Model: _________________________

Email to Send Appraisal:____________________________ Year:_________

Contact Phone Number:_____________________________

List All Options & Condition:

Payment Information
Credit Card #	Expiration Date
Name on Card	CSV Code

I herby authorize Millennium Trailers to charge my credit card for $99 to complete a trailer appraisal:

______________________________________ _________________________

Authorizing Signature Date

E-mail back to ta@milltrailers.com or fax to 317-862-3200 with pictures of the trailer. Once your form has been submitted, call 317-862-3000 and ask for Bill. No trailer appraisal information will be given over the phone, unless the form is complete. Forms without payment information or forms that are not signed will be discarded. Master Card, Visa and American Express accepted.