Service Request - Automotive Customer Details First Name * Last Name * Street Address * Suburb * City * Mobile * Landline Email Address * Product Details Dealer and Branch of Purchase * Product Type * - Select -PaintLeatherFabric Warranty Number Invoice or VOSA number Product Purchase Date * Day12345678910111213141516171819202122232425262728293031 Day MonthJanFebMarAprMayJunJulAugSepOctNovDec Month Year20132014201520162017201820192020202120222023 Year Make * Model * Year * Colour * Registration * Copy of Invoice or VOSA Add a new file Upload More informationFiles must be less than 5 MB. Allowed file types: gif jpg jpeg png txt pdf doc docx. Service Request Details Reason for Service Request Cut Scratch Scuff Stain Other Describe what has happened to the vehicle? * When did it happen? * What part of the interior is stained or damaged? * What caused the stain or damage? * What have you used to remove it? * Additional Notes * Photo at least one close up photo and one of the whole panel (door, bonnet etc) Add a new file * Upload More informationFiles must be less than 10 MB. Allowed file types: gif jpg jpeg png pdf. Submit
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