1
2
3

Claims

Product



Vehicle Year, Make, & Model



Vehicle Trim



Part is being installed by



Your Name



Company Name



Invoice No



Phone No



Your Email



Description of problem



Pictures - Close up



Pictures - Close up 2



Pictures - Close up 3



Pictures - Overview (picture of entire part on the vehicle)



Pictures - Overview 2 (picture of entire part on the vehicle)



Pictures - Overview 3 (picture of entire part on the vehicle)





+