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First Name*

Last Name

Email*

Phone*

Describe Accident / Damage:

Will You Be Submitting an insurance claim?

Yes

Not Sure

VIN#:

Vehicle Year, Make, Model (Ex. 2013 Chevrolet Impala):

Is the vehicle safe to drive?

Yes

Comment: We recommend you send us 4 corner shots of vehicle and multiple angles of the damaged area of the automobile. Try to get photos of the damage from 10 feet away and up closer within 2-3 feet away. Photo quality is important for more accurate estimates.

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