Request for Quotation

Request for Quotation

Request for Quotation Form

(All fields on the form are mandatory)

    Intended Brand

    Model and Engine

    Vehicle status

    Applicant's Full Name

    Client Type

    Citizen Card or Passport No.

    PT Taxpayer Number



    Describe as best as you can, including colors, finishes and options:

    How did you get to us?

    I declare that I understand that I will receive a quote for individual and personalized car sales, so there is no binding character of the DIHALMA Automotive brand.

    Because there is interest on my part, and because I am interested, I am requesting a Car Purchase Quote, and I now assume the honorable commitment not to disclose any data or information relating to the quotation received.

    I've read and I accept Privacy policy.

    [anr_nocaptcha g-recaptcha-response]

    *A copy of this form will be sent to the Customer via email, along with the quote.

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