VehicleWorksheet Vehicle Information Name * Name First First Last Last Email * Phone * Year, Make and Model of Your Vehicle * Current Mileage on Vehicle * Miles Driven for Business in the Prior Year * Do you own or lease your vehicle? * Own Lease Purchase Price * Monthly Lease Payment * What is your annual registration fee? * Monthly insurance cost * Do you have a loan on this vehicle? Yes No Beginning of year balance End of year balance Did you have any repair or other costs outside of gas? * Yes No Repairs and Other Expenses Description Amount Spent plus1 Add minus1 Remove Did you sell or trade in this vehicle? * Yes No Date of Sale or Trade In Submit If you are human, leave this field blank.