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Repair / replace window
What is the car brand?
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Which model is it?
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In which year was it first placed on the market?
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What's the license plate?
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What is the current mileage?
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Type approval (field 24 vehicle ID card)
(optional)
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Which windows are affected
Windshield
Sidewindow
Rear window
Panoramic roof
Miscellaneous
What kind of damage is it?
Crack
Single impact
Multiple impacts
Miscellaneous
How is your car insured?
Fully comprehensive or partially comprehensive (please specify insurance company)
I pay the costs myself
I don't know it
Miscellaneous
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Yes
No
Optional Information
Remarks
If there’s anything else you’d like to add.
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Please describe your job request
Do you have a voucher code?
Yes, I have a voucher code
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