adaptive equipment
Modified Vehicle Inventory
Van Conversion Options
Adaptive Vehicles 101
Rentals of Modified Vehicles
Our Fleet of Handicap Vehicles
Service for Adaptive Vehicles
Financing for Modified Vehicles
About Rideaway and Vehicle Conversion Options
Sell Your Vehicle to Us   |   Contact Us   |  
RideAway
mobility equipment
disabled equipment
 adaptive equipment

Sell Your Vehicle to Us

Please fill out the form below

Please Note: Ride-Away does not buy vans that are older than 10 years old unless it is part
of a trade in on a purchase.
* indicates required field

Your Information
Name: *
Address: *
City: *
State: *
Zip Code: *
Home Phone (with area code): *
Work Phone (with area code):

Vehicle Information
VIN#:
Trade-In: Yes    No
Year:
Make:
Color:
Engine:
Model:
Mileage:
Transmission:
All tires match?: Yes    No
Tread Depth:
Asking Price:

Vehicle Options
Power Windows: Yes    No
Power Door Locks: Yes    No
Air Conditioning: None    Front    Back    Both
Blowing Cold Air: Yes    No
Cruise Control: Yes    No
Fourth Door: Yes    No
Conversion Van Interior: Yes    No
If so, is it from OEM: Yes    No
Tilt Steering: Yes    No
Privacy Glass: Yes    No
Leather Seats: Yes    No
CD Player: Yes    No
Aluminum Wheels: Yes    No
Wheel Base: Short    Long
Side Door: Swing    Slide
Please list any problems with the interior

Conversion Components Information
Name of Conversion:
Raised Roof Top: None    Hi Top    Low Top
Running Boards: None    Aluminum
Metton    Fiberglass
Other Details

Handicap Modification Information
Raised Door: None    Side    Rear
If so, at what height:
Lowered Door: None    Full Drop    Driver Drop
Passenger Drop    Center Only
If so, at what height:
Lift Type:
Lowered Floor Mini-Van: Yes    No
Power Door: Yes    No
Kneel: Yes    No
6-Way: None    Driver    Passenger
6-Way Power Door: Yes    No
Exterior Switches: None    Toggle    Magnetic
Hand Controls (Type):
Wheelchair Tie-Downs (Type):
Number of Locations:
Reduced Effort: Steering:
Braking:
Modification done by:

*For the purpose of securing credit from you, I certify that the above information is true and complete to the best of my knowledge.  Applicant further certifies that I have attained the age of majority. 
Seller Signature:
Date:
E-mail: *