1. 販売店情報
Dealership Information
積載車が車両まで進入できるか、近くまでしか入れないか、駐車場・門・鍵・営業時間などの注意事項を入力してください。
Please describe truck access, vehicle location, gates, keys, parking restrictions, business hours, or other pickup instructions.
2. 車両基本情報
Vehicle Information
車検証または車体の車台番号を入力してください。
Enter the full chassis number from the inspection certificate or vehicle body.
車検満了日 - Vehicle Inspection Expiration Date · Optional
3. 車両状態
Vehicle Condition
走行状態 - Running Condition · Required
引取希望時期 - Desired Pickup Timing · Required
入力された金額は参考希望価格として確認いたします。市場相場、車両状態、引取条件を確認したうえで、最終金額をご相談させていただく場合があります。
This amount will be reviewed as your asking price. After checking market value, vehicle condition, and pickup conditions, the final price may be discussed.
5. 写真・書類アップロード
Photo & Document Uploads
写真は内容確認のため、できるだけ明るい場所で撮影してください。Clear photos help us review the vehicle faster and respond more accurately.
6. 確認事項・同意事項
Confirmation, Privacy Policy & Terms of Service Agreement
I confirm that I am authorized to submit the company, contact, vehicle, pickup-location, photo, document, asking-price, and service-related information included in this request. I agree to DERA International's Privacy Policy and Terms of Service, and I understand that DERA may use and share submitted information with relevant business partners, contractors, transport providers, storage providers, insurance providers, and service providers as necessary to review, appraise, pick up, purchase-review, transport, document, or otherwise support this request.
I understand that submitting this form is not a final purchase agreement, sales contract, pickup agreement, payment obligation, or final acceptance by DERA International. I understand that DERA may decline the purchase/pickup request or revise conditions after reviewing vehicle condition, documents, ownership/sale authority, pickup conditions, storage situation, asking price, and market value. Any actual purchase, pickup, payment, transfer of ownership, or related condition must be confirmed separately in writing or by a method approved by DERA International.
I understand that DERA International may act as a coordinator for pickup, transport, storage, review, documentation, or related services unless separately agreed in writing, and that some services may be performed by independent third parties. I understand that claims for damage, loss, delay, theft, storage/transport/pickup issues, or service issues outside DERA's direct control may need to be handled through the responsible carrier, storage provider, service provider, insurer, or related party, and I agree to cooperate with DERA in that process. I also understand that insurance is not automatically included unless confirmed in writing.