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Questionnaire
Get a Quote

If you or your company could benefit from our Commercial Fleet Program, please take a moment to complete this questionnaire and fax it to us at (480) 496-6478.
Thank you for your time.

* required field

*First Name:
*Last Name:
*Phone Number:
Fax:
Email Address:
Business Name:
Purchasing Agent:
Address:
City:
State:
Zip:
Occupational Field/Business Classification:
How many vehicles does your company own?:
How many miles do you usually keep vehicles before you replace them?:
Less than 50K
50K-100K
Over 100K
What type(s) of vehicles do you use in your business?
Pickup Trucks
Sport Utilities
Passenger Cars
Passenger Vans
Cargo Vans
Other
What kind(s) of special equipment options do you require?
Service Bodies
Flat/Stake Beds
Power Liftgates
Special Shelving
Disability Alterations
Dump Body
How soon do you anticipate replacing or purchasing your next vehicle?
1-3 mo.
3-6 mo.
6-9 mo.
9-12 mo.
12+ mo.
Would your company be interested in establishing a Pre-Approved Line of Credit?
Yes
Not at this time
I need more information
If your company does not currently have a registered Fleet Number with Chrysler, would you like to apply now?
Yes
Not at this time
Comments:

 

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