Value Your Trade
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At Jim Baier Inc., you can Value Your Trade towards a great selection of new Lincoln, Mercury, Chrysler, Jeep, Dodge, and Ford vehicles. We also have a large selection of pre-owned vehicles to choose from. Jim Baier Inc. in Fort Madison is proud to be an automotive leader in the community. Jim Baier Inc. serves the Quincy, Burlington, Keokuk, and Mt Pleasant areas. Call us today at 1-866-483-1796 for a great deal on your next vehicle purchase.
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Contact Information

Contact Information
First Name: *  
Last Name: *  
Address: *  
City: *  
State Issued:  
Zip: *  
(Area Code) Daytime Phone: *  
EMail: *  

Vehicle Information

Vehicle Information
Year:  
Make:  
Model  
Trim Level (if known)  
Exterior Color  
Interior Color  
Mileage: *  
Vehicle Identification No.: *  
Doors  
Cylinders  
Liters  
Transmission  
Lien Holder  
Estimated Payoff  

Vehicle Options

Vehicle Options
AM/FM Radio  
Cassette  
CD  
CD Changer  
Power Windows  
Power Locks  
A/C  
Rear A/C  
ABS  
Cruise Control  
Tilt Control  
Roof Rack  
Sunroof  
Alloy Wheels  
Drive Train  
Tow Package  
Dual Air Bags  
Side Air Bags  
Leather Seating  
Power Seat(s)  

Overall Vehicle Condition

Overall Vehicle Condition
Rate the condition of the following: 1 being Poor, 10 being Excellent.  
Metal/Paint (Scratches, dings, dents, rust, fading) *  
Tires (50% tread wear - replacement)  
Upholstery (Tears, burns, stains)  
Glass (Fractures, spiders, chips)  
Clutch (Clutch slipping)  
Brakes (Squeaky, noisy)  

Collision History

Collision History
Has your vehicle ever been involved in a collision?  
If yes, was a Body Shop estimate of repairs written?  
Were Body Shop repairs performed? *  
Was the vehicle repaired to your complete satisfaction? *  

Exterior Condition

Exterior Condition
Are any of the painted surfaces scratched, rusted, or faded? *  
Are there any dents and dings? *  
Have any of the painted surfaces been repainted or touched up? *  
Does any of the glass have fractures, spiders, or chips? *  

Interior Condition

Interior Condition
Does the upholstery have tears, burns, or stains? *  
Does the stereo system or any of its components need repairs? *  
Do all of the gauges and dash functions work? *  

Mechanical Condition

Mechanical Condition
Does the engine need any repairs? *  
Does the transmission need any repairs? *  
Are the brakes squeaking or in need of repair? *  
Is the clutch slipping or need any repairs? *  
Has the transmission or engine ever been replaced? *  

Questionnaire

Questionnaire
Has the vehicle ever been a taxi, rental car, or police car?  
Has the vehicle ever been in water deeper than the midpoint of the tires?  
Has the vehicle ever been declared a "Flood" vehicle?  
Is the vehicle's frame in need of repair?  
Has your vehicle's frame ever been repaired?  
Has the vehicle ever had a salvage title?  
Is this a "lemon law buyback" vehicle  
Has the vehicle ever been declared a total loss? *  
Is the vehicle air bag in working order?  
Has the vehicle air bag ever been deployed?  
Do you have any of the service records for this vehicle?  
Do you have records for any oil change within the last 5000 miles?  
Is the catalytic converter attached and working properly?  
Are the inspection stickers current?  
Has the spare tire ever been used?  
Do any of the tires need to be replaced?  
Is the pollution control equipment attached and working properly?  
Is there anything else we should know about this vehicle?
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