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RS Fukuyama visit and buy value assessing enquiry form

One of our staff will answer you by email or telephone after you send the form.

0120-002-819 (Link for smart phones)
084-945-8825 (Link for smart phones)

Please order by completing this form.

Customer information
Email addressEmail address
Confirm email addressconfirm mail address
Nameyour name
Telephone numbertelephone number
Postcodepostcode	Look up postcode
Addressaddress	Select the prefecture 　　　　　　　　　　Restricted to Chugoku, Shikoku, Kinki and part of Kyushu City, ward or village Street number
Preferred date for value assessingDays	年　月　日 Enter your preferred date for value assessing if you have one.
Motorbike details
Makermaker
Engine displacementengine displacement
Modelmodel	例 Example: CBR400F3
Yearyear	例 Example: Heisei 10 or 2005 model 　* Enter “unknown” if you don’t know the year.
MileageMileage	km
Frame no.fream	例　 Enter if known.
Vehicle inspectioncustom	Yes　　 No　　 * For 400 cc and larger motorbikes
Third party liability insurancecustom	Yes　　 No
Number platecustom	Yes　　 No
Colorcolor
CustomizedCustomized	Yes　　 No　　 * Enter details if the muffler, etc. has been customized.
Condition of motorbikeCondition of motorbike
Quote from other companyQuote from other company	JPY　 * Please enter a quote from another company for reference if you have one.
Requested pricemoney	JPY　 nter your requested price if you have one.
Opinions or questions Please enter any other details if applicable.qestion
Sending confirmationsending confirm	Confirm that you have checked all the above information.
Sendsubmit send

Customer information