Book a car

WELCOME TO OUR CAR BOOKING SERVICE

Completing this form should take no longer than 5 minutes provided you have all the information handy, if you don't have all the information right now don't worry, fill in what you can call if you have any questions.

To ensure the successful recovery of costs applicants must co-operate with us by providing detailed driver and accident details and all the associated information and assistance we need to settle the claim for cost recovery. If you prefer to speak to one of our staff please contact us.

Make sure you have these documents handy

  • Copy of current Driver's Licence
  • Copy of current Vehicle Registration
  • Copy of current Vehicle Insurance Policy

APPLICATION SUCCESSFULLY SUBMITTED

Thank you for your application. We have sent you a confirmation email

We 'll call you back by approximately

4:00pm

Or if you would like to speak with us now you can call us 24/7 on 1300 100 121

Next steps

It appears you are missing some information in the following sections. Please try and obtain these details before we call so we can process your application quickly.

  • At fault driver details
  • Witness & police details
  • Accident details

Confirmation details

Driver details

First name test

Mobile 0400 000 000

Last name t

Home phone-

Date of birth05/03/1987

Address (required)test

Your licence details

Licence number15689566

Licence issuerAustralia - NSW

Licence expiry08/2019

Car details

Makenull

Modelnull

Yearnull

Registration number123

Use-

Are you owner of the car?yes

Have you made an insurance claim?Personal

At fault driver details

First name test

Mobile 0400 000 000

Last name t

Home phone-

Date of birth05/03/1987

Address test

Their licence details

Licence number15689566

Licence issuerAustralia - NSW

Licence expiry08/2019

Incurance company NRMA

Make Subaru

Type of cover Comprehensive

ModelForester

Claim number-

Registration numberABC535

Vehicles involved

-

Accident information

Accidents details-

Accidents date21/04/2017

Accidents time3 : 53 : 00 PM

Accident location-

Damage to your vehicleRear bumper faller off, bent rear left axle.

Smash Repairer name-

Repairer suburb-

Estimate date

Assessment date

Start date

How did the car get to the repairer? -

Witness & police details

Police contact name

Police phone

Police event number

Witness name

Witness phone