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Savanorių pr. 174R
+370 659 33251
info@sherlog.lt
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About us
OUR WORK
Operation principles
GUARANTEE
PRICES
RULES OF PERSONAL DATA
SYSTEM ORDER
CONTACTS
Customer information
Name, Surname / Name of company
*
Personal code / Company code
*
VAT code
Contact number(s)
*
Address
*
E-mail address
Type of Payment
*
Bank transfer
Cash
Vehicle
Vehicle body number
Registration number
Manufacturer
*
Audi
BMW
Infiniti
Jaguar
Jeep
Lexus
Mercedes Benz
Mitsubishi
Nissan
Porsche
Toyota
VW
Volvo
Other (write)
Year of manufacture
*
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
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1984
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1982
1981
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1976
1975
Color
*
Gold
White
Bronze
Yellow
Black
Blue
Orange
Gray
Red
Brown
Beige
Silver
Purple
Kirsch
Green
Light blue
Light gray
Light green
Other (write)
Model
*
Insurance company (CASCO insurance holders)
Leasing company
No
Yes (write)
System unit
*
Sherlog Mini Comfort (II level system)
MD Guard (II level system)
Sherlog Premium Comfort (I level system)
Sherlog Optimum Comfort (I level system)
Sherlog Premium Ultra (I level system)
Frequency of service payments
*
once in 3 years
once in a year
every month
other
Other security equipment fitted
Yes
No
If the vehicle is fitted with any other security equipment, please fill in the following.
Brand
Workshop
Additional information
Name, Surname of an authorized representative
*
Email address of the authorized representative
*
I confirm that the information provided in this form is true, complete and accurate.
*
I confirm that the information provided in this form is true, complete and accurate.
Message
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**
a valid email address is required. For any questions or assistance, please call +370 659 80858.
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