Claims

Approximate date that you first noticed the problem? *

Have you attempted to resolve the problem? *

VS2000 Claim Initiation Form

Year: *

Make: *

If yes, What method did you use to try to remedy the problem?

Email: *

Customer Full Name: *

Selling Dealer: *

Customer Address: *

What/Where on the vehicle is the problem? *

Upload VS2000 Policy

Appearance Protection that specializes in protecting automobiles

(Both inside and out) from environmental elements, stains, and more!

Model: *

Upload Buyer's agreement

Phone *

Confirm *

"I hereby swear and/or affirm that the answers provided herein are true and correct."

Today's Date *

Purchase/Install Date: *

What caused the problem? *

Fill out the form below. Any person who knowingly, and with intent to defraud, files a statement of claim containing any false or misleading information may be guilty of fraud, and may face criminal penalties in accordance with state law. The information on this form is for collecting data only and is not in any way an approval or authorization.

Please feel free to email claims@driveonsvcs.com

or call 800-343-6643 with any questions.

To File a Claim:

1. Fill out the VS2000 Claim Initiation Form below

2. You will need to attach a copy of your VS2000 policy

3. You will need a copy of your buyer's agreement for this vehicle.