01/30/2026
Elite of Durham text us @9196824576
Vehicle Referral Leads Intake Form
Vehicle Referral Leads Intake Form
Please answer each question as completely as possible. This helps us find the best options for you.
Customer Information
Full Name: ________________________________
Phone Number: ________________________________
Email Address: ________________________________
Preferred Method of Contact: ☐ Phone ☐ Text ☐ Email
Best Time to Contact You: ________________________________
Vehicle Details
Desired Vehicle Year (or Year Range): ________________________________
Make: ________________________________
Model: ________________________________
Body Style: (Sedan, SUV, Truck, Van, Coupe, etc.) ________________________________
Mileage Range (if applicable): ________________________________
Budget & Financing
Price Range: $________________ to $________________
Down Payment Amount (if any): $________________
Will You Be Financing? ☐ Yes ☐ No ☐ Not Sure
If Financing, Preferred Monthly Payment: $________________
Have You Been Pre‑Approved? ☐ Yes ☐ No
Credit Situation (optional): ☐ Excellent ☐ Good ☐ Fair ☐ Rebuilding ☐ Prefer Not to Say
Vehicle Preferences
Preferred Color(s): ________________________________
Interior Preference: ☐ Cloth ☐ Leather ☐ No Preference
Fuel Type: ☐ Gas ☐ Diesel ☐ Hybrid ☐ Electric ☐ No Preference
Transmission: ☐ Automatic ☐ Manual ☐ No Preference
Must‑Have Features: (Navigation, Backup Camera, Sunroof, Third Row, etc.)
Deal‑Breakers (if any):
Location & Availability
Country: ________________________________
State/Province: ________________________________
City: ________________________________
How Soon Are You Looking to Purchase? ☐ Immediately ☐ Within 30 Days ☐ 1–3 Months ☐ Just Browsing
Trade‑In Information (if applicable)
Do You Have a Trade‑In? ☐ Yes ☐ No
