ABN 56 103 618 499
Address 3/3 Rocklea Dr, Port Melbourne, VIC 3207
Postal PO Box 183, South Melbourne, VIC 3205
Email [email protected]
Website www.southgatesalpack.com.au
Phone 1300 132 500
Fax 1300 500 150
NEW CAR DETAILS
Make Model Variant
Body Sedan Wagon 3 Door Hatch
5 Door Hatch Other ______________________________
Transmission Auto Manual Fuel Type Petrol Diesel LPG Hybrid
Options
Metallic Paint
Floor Mats
Cruise Control
Window Tint
Factory Satellite Navigation
Portable Satellite Navigation
Bluetooth
Front Parking Sensors
Rear Parking Sensors
Bonnet Protector
Headlight Protectors
Roof Racks
Tow Bar ( _________ kg capacity)
Other _______________________________
TRADE-IN VEHICLE DETAILS (if applicable)
Make Model Rego No.
Contact Name Contact Phone
Location of Vehicle to be Inspected
Date and Time for Inspection (optional)
NOTE: Where you have specified a date and time for inspection, we recommend at least 3 business days notice is given to ensure the vehicle valuers can set aside the requested date and time.
NOVATED LEASE DETAILS
Annual Kilometres Select Lease Term
1 Year 4 Years
2 Years 5 Years
3 Years
Annual Gross Salary
Pay Cycle Frequency
Garaged Postcode
Return form to Southgate via Fax: 1300 500 150 OR Email: [email protected]
NOVATED LEASE - QUOTE REQUEST FORM
Please request a quote, please complete all details on this form and FAX to 1300 500 150.
CONTACT DETAILS
Title Given Name Surname
Employer Name
Phone Mobile Fax
Delivery State Delivery Suburb
