Section 8 cont... Describe how the loss / damage occurred.
Was there any damage to your vehicle prior to this loss/damage occurring? If Yes,please provide details.
Please indicate on the diagram below,the area of damage to your vehicle by marking the cross box closest to the damage
Was your vehicle towed from the accident scene? If yes,by whom and to where was it towed?
Is your vehicle currently at a repair shop?
If yes,at which repair shop?
If no,please provide contact details so we may arrange to assess damage to your vehicle
This information is,to the very best of my knowledge, true inevery respect.
Name of the Driver who is responsible for the car at UTS
Name of your supervisor at UTS
Please print the form for your copy
Save: To save the completed form(with the data) please save the form on your computer with a different name. The data will be lost if you close the form without saving. Email: start new email message, attach the form saved on your computer and email it to: firstname.lastname@example.org or email@example.com Address: Lumley House Level 9, 309 Kent Street, Sydney 2000. Fax : 9248 1135 Ph: 9248 1263