Name *
Age *
Occupation *
Address *
Phone *
E-mail *
Budget *
Your preferred category of vehicle segment
 1) Small cars
Yes No
 2) Mid. size cars
Yes No
 3) Premium Cars
Yes No
 4) Luxury Cars
Yes No
 5) Sport utility vehicle
Yes No
 6) Others/Van/Jeep etc
Yes No
You have any disability
Your height
Your weight
The Car you use now
How long you are using your Car
The Terrain you live in
Hilly Area 
Coastal Area
Your place of living
Your travelling distance per day
Your dream car
Your need an individuality car
Yes No
Your travel city or long distance more
Your want mileage for your car
Yes No
You need a value for money car
Yes No
You like speed drive
Yes No
Have you attended or participated in motor sports event
Yes No
You use your car self /driver
You have a color preference for your car
Yes No
How many members are there in your family
You often go for picnic
Yes No
You service your car in authorized service centre
Yes No
You maintain your car at the periodic service as prescribed by the manufacturer
Yes No
You have no claim bonus for the insurance of your car now
Yes No
Your insurance company
Any particular matter you want mention about your new car which you are going to buy
You like more extra accessories in your car
Yes No
You request finance
You use 2 wheelers
Yes No

I here by states that the above information given by me are true and best of my knowledge.