Damage / Theft Report Form

Company Name Employee Name Contact Number Vehicle Make / Model Date of Accident Time of Accident Place of Accident Present Kms ALD Contract No Date of Registration Door to Door Service Registration No Speed of Vehicle (at the time of accident)

Driver Details Driver Name
(at the time of accident)

FIR Details (if necessary) Date of FIR FIR No. / Diary No. Address of Police Station Valid Upto

Valid Drivers Licence No Vehicle Authorised to Drive Issued by

Copy of Registration Certificate & Driving License must accompany this report form. Brief description of the accident justifying the damage on the vehicle including third party damage. If any
(specify in detail and use additional sheet, if necessary)


(Name & Signature)

* Damage to the vehicle that is not justified because of the above accident will not be covered in the claim * Fill separate forms for individual incidence of damage. Sign & send to ALD within 48 hrs of occurance of the event. E-Mail version of this form will not be accepted. * Wherever FIR is mandatory, repairs will not commence unless FIR details are provided. FIR details are mandatory

For Internal use Only
Workshop Name Contact Person Mobile No Insurance Company Name Policy Number Validity Peroid PDLW RC Verified DL Verified FIR (if Required) Yes / No Yes / No Yes / No Workshop Visit Date Suveryor Name Suveryor Contact No Suvery Date Estimate Amount Estimate Amount Passed Claim Eligble Estimate Delivery Date Actual Delivery Date Payment Mode ALD / Dealer

ALD Road Side Assistance No :1800 (Round the Clock)

- 102 - 8100 alternate no. 0124 - 4278181

ALD Toll Free No : 1800 - 209 - 5253 [Mon to Fri Time 0900 - 1730 hrs]

Fax : Mumbai - 022 61933213 ● Delhi - 011 4661 3222 ● Bangalore - 080 4061 3248 ● Hyderabad - 040 2335 5990

Email : lets.drivetogether@aldautomotive.com ● Web: www.aldautomotive.co.in

On consultation with the repairer and the insurance company. stereo panel. If the vehicle is safe to drive. ALD shall report the schedule of vehicle repair and its time for completion. Theft or loss of key Take extreme care to protect all sets of keys provided with the vehicle. you need to report it to the Police. We at ALD would like to wish you safe driving and a happy motoring experience . ALD shall arrange as per your contract for appropriate insurance cover of the vehicle and its renewals and this would cover any external damage to the vehicle based on the approval from the insurance company. Report the matter immediately to ALD. In the unfortunate event of a damage or accident of the vehicle. In the event of loss of key. Note: Damaged vehicle when driven could result into additional damage to the vehicle which is not covered under insurance and hence will be rebilled. lodge a complaint with the police and send a copy of the First Information Report (“FIR”) or receipt acknowledged copy of the statement given.INSURANCE & DAMAGE REPAIR SERVICES You need to call on the Toll free number 1800-209-5253 to book your vehicle for any attention that it may need. Upon receipt of the accident report. attempted theft or vandalism. we will be happy to discuss and clarify the same. etc). Damage Theft Form provided in the ALD Service Guide be filled with care and sent to ALD. In the case of theft. we appoint a surveyor for inspection and assessment of repairs. only then the repairs on the vehicle can start. While handing over the vehicle for repairs check it thoroughly and take out all personal belongings. always check for safety of all occupants and then the vehicle and take all precautionary measures to avoid additional damage (check water and oil levels. take it to the nearest safe place and park. The ALD Service Guide contains all of it and will be of assistance to you and should you have any questions on it.

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