• Damage reporting form

    Standard Damage reporting form for car glass

Damage reporting form

Report damage?

Click on the link below and use the downloadable version of the official auto glass damage reporting form.

 

Give us a call or fill in our contact form (“Contact us today”) on the right side of the page if you have any trouble downloading the form or if you have any questions about filling it in. We are happy to help you fill in the damage reporting form.

 

You need Adobe Reader to open the form if you are not using Google Chrome which has a built-in version of Reader.

Why should you use our damage reporting form?

  • Information from customers and our shops is collected on the same form
  • Streamlining the documentation process
  • Easy to fill in
  • We are happy to clarify anything that seems unclear.

Please contact us using our contact form, e-mail, telephone or just drop by and we will help you.

What needs to be filled in on the form?

The customer needs to fill in the top white part of the damage reporting form.

1. Information about you and your insurance

Type the name of your insurance company for the car.
Your name, phone number, e-mail and address should also be typed here.
If you are a registered self-employed person or sole proprietor who is subject to value added tax, please inform us by checking the box: YES / NO.

2. Your car

Fill in the information about make and model of the car to be repaired.
Your vehicle’s make, type, model and registration number. Whether it is a passenger car, van, truck, bus or another type of vehicle.

3. The damage

Fill in any information about the damage, where it took place and at what time.
When did the damage occur: date/time
Location of accident/damage: County/municipality/road/place
Did an official vehicle inspection before the damage demand that the window(s) be replaced? Please tick this box: YES / NO.
Tick off each box for the windows that are damaged: Windshield, Side window, Rear window or Other.

4. Signature

Please fill in the date and sign as either the driver of the car or as the insured party.

The rest of the form can be filled in by the shop.

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