Service Request - Automotive Customer Details First Name * Last Name * Street Address * Suburb * City * Mobile * Landline Email Address * Product Details Store and Branch of Purchase * Product Type * - Select -PaintLeatherFabric Warranty Number * Invoice Number * Product Purchase Date * Day12345678910111213141516171819202122232425262728293031 Day MonthJanFebMarAprMayJunJulAugSepOctNovDec Month Year20122013201420152016201720182019202020212022 Year Make * Model * Colour * Registration * Copy of Invoice Add a new file Upload More informationFiles must be less than 2 MB. Allowed file types: gif jpg jpeg png txt pdf doc docx. Tick this box if previously supplied Tick this box if previously supplied 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 Add a new file * Upload More informationFiles must be less than 2 MB. Allowed file types: gif jpg jpeg png pdf. Submit
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