Repair-Form

Step 1/4

Plan Holder Details

Please complete the Plan Holder’s details below.

Driver's Name*

Driver's Contact Number*

Vehicle Registration Number*

All fields are required to be completed accurately.

Next Step

Step 2/4

Repairing Garage Details

Please complete the Repairing Garage’s details below.

Business Name*

Business Address*

Business Postal Code*

Business Contact Number*

Contact Name*

Business Email*

VAT Number

All fields are required to be completed accurately.

Next Step

Step 3/4

Vehicle Details

Please complete the Vehicle Details details below.

Current Accurate Mileage*

Fault Date*

Booking Date (if applicable)

Reported symptoms*

Labour rate (exc VAT) per hour*

All fields are required to be completed accurately.

Next Step

If you would like to upload any documents or images to support the repair request, you can do so here:

Upload File

Max file size 10MB.

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Submit Assessment FormI understand that no repairs should be progressed prior to authorisation being received from Warranty First. Any work carried out prior to authorisation being received could prevent authorisation being issued. Completing this form in no way guarantees any authorisation or payment from Warranty First.

All fields are required to be completed accurately.

Repairer's Assessment Form.

Plan Holder Details

Repairing Garage Details

Vehicle Details

Parts Required

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