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Vehicle Information Survey

Dear Sir or Madam, please take a few minutes of your time to complete the following questionnaire.

Secured
1

How many vehicles do you own?

Please select the number of vehicles you own.
2

Rate the condition of your vehicles

Rate the condition of your vehicles on a scale of 1 to 10.
3

Please describe your vehicle(s)

Please provide details about your vehicle(s) including make, model, and year.
4

What is the primary use of your vehicle(s)?

Select the primary use of your vehicle(s).
5

Do you have insurance for your vehicle(s)?

Select yes if you have insurance for your vehicle(s).
6

How often do you service your vehicle(s)?

Select the frequency of servicing your vehicle(s).
7

Have you made any modifications to your vehicle(s)?

Select yes if you have made modifications to your vehicle(s).
8

What is the mileage of your vehicle(s)?

Please enter the approximate mileage of your vehicle(s) in kilometers.
9

Would you consider purchasing an electric vehicle in the future?

Select yes if you would consider purchasing an electric vehicle in the future.
10

Any additional comments about your vehicle(s) that you would like to share?

Feel free to provide any additional comments or details about your vehicle(s).