Vehicle Repair Declaration

Vehicle Repair Declaration

DD slash MM slash YYYY

Process of Repairing

DD slash MM slash YYYY
Arrival Type
Drivable
Dismantled
DD slash MM slash YYYY
DD slash MM slash YYYY
DD slash MM slash YYYY
DD slash MM slash YYYY
DD slash MM slash YYYY
DD slash MM slash YYYY
DD slash MM slash YYYY
DD slash MM slash YYYY
Sublet Type
DD slash MM slash YYYY
DD slash MM slash YYYY
DD slash MM slash YYYY

Declaration

I hereby declare that the above information is a true account of the sequence of events that occurred in the process of repairing the above vehicle. I authorise Carbiz Rentals to disclose this information to third parties such as other insurers, reinsurers, loss adjusters, external claim data collectors, investigators and agents, or other parties as required in their effort to recover costs related to the provision of accident replacement vehicles.

DD slash MM slash YYYY
This field is for validation purposes and should be left unchanged.
Carbiz