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Home > Contact Us > File Interior Claim

ECP Incorporated: File Interior Claim Form
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red color - denotes required fields
First Name:  
Last Name:  
Address:  
City:  
State:  
Zip:  
-
Home Phone:  
 - 
Work Phone:  
 - 
Email:  
Scan Vehicle Reg:   Allowed File Types : txt,csv,doc,pdf
Scan Warranty:   Allowed File Types : txt,csv,doc,pdf
Warranty Number:  
Year:  
Make:  
Model:  
Vin #:  
Current:  
Mileage:  
Color:  
In your own words, describe your problem:
Location of damage on the vehicle:  
Description of the problem:  
Date current damage was first Observed:  
Material on which damage has occurred: (please check all that apply)
 
Explain Other:  
Please check the box and explain the stain type, mark where indicated.
 


Explain Other:  
Please mark the description for the damage on your vinyl or leather.
 
Explain Other:  
Please submit photos or scans of damage or information:
Photos of Damage 1:   Allowed File Types : jpg,jpeg,gif,bmp
Photos of Damage 2:   Allowed File Types : jpg,jpeg,gif,bmp
I Certify that the above information is correct and accurate to the best of my knowledge. By Clicking submit, you agree that these statements are true.

Note : Repairs should not be performed until liability for damage has been determined by ECP, Inc. Repairs performed prior to any determination will not be reimbursed. Thank you.

  
ECP

ECP
© 2008 ECP Incorporated
11210 Katherine's CrossingEPC Suite 100EPCWoodridge, IL 60517EPCToll Free: 800.323.3521EPCFax: 800.409.5195
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