Contact Name
Contact Email
Company Name
TGL Account Number
Customer Ref No
Part Number
Quantity
Has item been fitted?
Is the vehicle registered in the UK?
Vehicle Reg
Date Fitted
Date Removed
Mileage Covered
Make
Model
Engine
Year Manufactured
Reported Fault
If your fault is not listed, please describe
Upload photos of the fault
Labour Claim
Attach invoice
Attach Invoice
Hourly Rate
Time Taken (Hours)
Total Labour Cost
Quantity of additional parts claiming for
Part number or description
Total ancillary claim
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