Market Value Report (ACV)

General Information:

Dealer Comps:

Vehicle Equipment:

Condition:

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Salvage Bids:

Date of Inspection:Claim#:

SCA File#:

Vehicle Owner:

Adjuster:

Year: Make: Model: VIN#:

Mileage

General Appearance of Vehicle:

General Appearance of Paint:

Condition of Tires: (%Worn) LF RF LR RR

Alum/Alloy WheelsLeather Seats

Cloth Seats

Manual TransmissionPremium Radio Tow PackagePower Seats

Nav. System

Power Sunroof

Cruise Control

Running Boards

Luggage Rack

Power Windows

Power Locks

Fog Lights

Additional Options:

Comp#1 Comp#2 Comp#3

Asking Asking Asking

Old Damage-Explain: Tax Rate

Average

Tax Total Recommended ACV

Mileage Mileage Mileage

Mileage Difference Mileage Difference Mileage Difference

Inspection Remarks:

Excellent Good Fair Poor

Excellent Good Fair Poor

Adjusted Value Adjusted Value Adjusted Value

Other Deduct-Explain:

Other Addt'l-Explain:

Adjustment

Adjustment

Adjustment

Adjustments

Year: Year: Year:

Year Difference Year Difference Year Difference

Bid#1 Bid#2 Bid#3Price: Price: Price: