Auto Booking Form
Auto Booking Form
Port of Discharge
*
Cotonou, Benin
Lagos, Nigeria
Lome, Togo
Tema Ghana
Carrier of Choice:
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Grimaldi
Sallaum Lines
JBH Pickup required?
*
Yes
No
Upload Copart/IAA Buyer Receipt:
Attach Files
Vehicle Condition
Run and Drive
Starts
Stationary
Salvage
Irreparable
CUSTOMER INFORMATION
Customer Name:
Customer Name:
*
First
Last
Company/Business Name:
Company Address:
Email
*
Phone:
*
CONSIGNEE INFORMATION
Consignee Name:
*
Consignee Address:
*
Consignee Email:
*
Consignee Phone:
*
VEHICLE INFORMATION
Make
*
Model
*
Year
*
Value in US Dollars:
*
VIN Number: