Residential Quote Form

Published on Pasha Hawaii (https://www.pashahawaii.com)

Residential Quote Form [1]

Please read this inquiry carefully. You must fully complete to the best of your ability and return back to us with attached pictures in order to receive a residential quote.

Please provide four pictures of the current state of your vehicle (front, back, and both sides). If you have any questions or concerns while completing this form please call us at (866) 363-7485 and we can assist.

Shipping Direction *

Mainland to Hawaii

Hawaii to Mainland

Hawaiian Island *

Shipper

First Name *

Last Name *

Phone *

Email Address *

Address *

City *

State *

Zip *

Residential Address

Is this address the pickup or delivery address? *

Pickup

Delivery

Address *

City *

State *

Zip *

Please make any additional notes regarding pickup/delivery below

Does the address you provided us for pickup/delivery have any restrictions for a Semi truck to access it? *

For example, is there a roundabout the driver would have to get through? Is it in a Cul de Sac? Are there any low hanging trees in the neighborhood that could scratch other vehicles on the trailer?

Available Dates

These dates are estimated and do not guarantee a pickup or drop off date.

Mainland to Hawaii Customers

Year

Month

Day

What is the last day we can pick up the vehicle?

Hawaii to Mainland Customers

Year

Month

Day

What is the first day we can deliver the vehicle?

Vehicle Information

Year *

Make *

Model *

VIN *

Weight (lbs) * pounds

Please enter only digits- no commas. (Decimal points ok.)

Length (feet or inches) *

Please enter feet or inches. Use only digits - no commas or decimal points.

Width (feet or inches) *

Please enter feet or inches. Use only digits - no commas or decimal points.

Height (feet or inches) *

Please enter feet or inches. Use only digits - no commas or decimal points.

Vehicle Condition

Is the vehicle fully operational? *

Yes

Does it have working brakes - emergency and regular? *

Yes

Does the vehicle have any leaks? *

Yes

Are there any special starting instructions? *

Yes

Please provide additional details here. *

Vehicle Photos

Front Image *

Files must be less than 3 MB.
Allowed file types: gif jpg jpeg png.

Back Image *

Files must be less than 3 MB.
Allowed file types: gif jpg jpeg png.

Drivers Side Image *

Files must be less than 3 MB.
Allowed file types: gif jpg jpeg png.

Passenger Side Image *

Files must be less than 3 MB.
Allowed file types: gif jpg jpeg png.

Are you active duty U.S. military? *

Yes

Enter Name as Signature *

Electronic signature *

By checking this box, I accept the name above as my electronic signature.

Source URL:https://www.pashahawaii.com/tools/vehicles/residential-quote-form

Links
[1] https://www.pashahawaii.com/tools/vehicles/residential-quote-form