Neotek Warranty Claim

Name / Business Name *

Address *

Suburb/City *

State *

Zip / Post Code *

Email *

Phone/Mobile *

Occupation *

Registration Number *

Make/Model *

New/Demo/Used *

Year of manufacture *

Delivery Date *

Delivering Dealership *

Cause *

Location *

Date of damage *

Date the damage was noticed *

Time of damage *

Time the damage was noticed *

Date the contamination was cleaned or removed from surface *

Time the contamination was cleaned or removed from surface *

Was the vehicle damaged or any unrepaired damage to the vehicle before the incident? *

If yes, please provide details

Is the vehicle comprehensively insured? *

If yes, please provide details

Please describe where the vehicle is damaged and attach photographs. If it is internal damage please attach photographs and describe. *

File Upload

Paint *

Name of product sold

Leather *

Name of product sold

Vinyl *

Name of product sold

Fabric & Carpet *

Name of product sold

Window Tint *

Name of product sold

Electronic Rust *

Name of product sold

I / we declare that all the information I / we have given is true and correct. *

Name *

Date *