Incident Details

Value of refund error: If you’re seeing an error when entering the value, make sure you’re only entering numbers—do not include £, €, or $ symbols in this field.

What happened?(Required)

Incident date(Required)

Value of excess you are requesting be refunded(Required)

In which country did the incident occur?(Required)

Vehicle make/brand(Required)

Document Uploads

If you have been given a passcode please enter it here

Please upload your booking voucher(Required)

Drop files here or

Accepted file types: jpg, png, pdf, txt, doc, docx, dot, dotx, jpeg, Max. file size: 10 MB, Max. files: 5.

Please upload a copy of your vehicle rental agreement with the company you collected your vehicle from(Required)

Drop files here or

Accepted file types: jpg, png, pdf, txt, doc, docx, dot, dotx, jpeg, Max. file size: 10 MB, Max. files: 5.

Please upload a copy of your bank/creditcard statement showing the charge made(Required)

Max. file size: 2 MB.

Please upload report from a roadside assistance service or a repair invoice(Required)

Drop files here or

Accepted file types: jpg, png, pdf, txt, doc, docx, dot, dotx, jpeg, Max. file size: 10 MB, Max. files: 3.

Please upload photos of the damage if you have any

Drop files here or

Accepted file types: jpg, png, pdf, txt, doc, docx, dot, dotx, jpeg, Max. file size: 10 MB, Max. files: 5.

Please upload any other photos/documents which maybe useful

Drop files here or

Accepted file types: jpg, png, pdf, txt, doc, docx, dot, dotx, jpeg, Max. file size: 10 MB, Max. files: 5.

Please provide further details(Required)

Please provide any additional information

Vehicle Hire Details

Booking/order/voucher number(Required)

Vehicle Registration Number (check your local hire agreement or damage report)(Required)

Date vehicle hire purchased(Required)

Vehicle hire start date(Required)

Vehicle hire end date(Required)

Your Details

First Name(Required)

Last Name(Required)

Address(Required)

Town/City(Required)

US States(Required)

Postcode/Zip(Required)

Country(Required)

Mobile Phone(Required)

Payment

Please ensure your bank details are correct. We can not refund the card you purchased with as we are a third party refunds service and do not hold your original purchase information. All bank data is encrypted and securely managed.

Payment

Credit Union Accounts can not receive refunds, please do not supply details for this kind of account or your refund will be rejected by your bank.

Please ensure your bank details are correct. We can not refund the card you purchased with as we are a third party refunds service and do not hold your original purchase information. All bank data is encrypted and securely managed.

Payment

Please ensure your Sort Code and Account Number are correct. We can not refund the card you purchased with as we are a third party refund service and do not hold your original purchase information. All bank data is encrypted and securely managed.

Name as it appears on your bank account(Required)