Making a Claim

Please complete the form below

Please consult your warranty book for more information.

NB: If the vehicle shows signs of imminent failure, DO NOT continue to use it. This may cause further damage for which you will be responsible. Please contact us. We will not pay for any stripping down of parts to determine the cause of failure unless we accept the claim. The maximum we will pay in total is shown on your schedule.

Warranty Number
Vehicle Registration No./Chassis No.
Current Mileage
Repairer Name
Contact Name at Repairer
Repairer Telephone Number
Repairer Fax/email Address
Customer Name
Brief description of fault
Cause of Failure
Parts Required and Costs
Labour Time and Cost per hour
Is the Repairer VAT Registered?		Yes ____ No