STEP ONE - CONTACT INFORMATION

STEP 2 - VEHICLE INFORMATION

STEP 3 - CLAIM DESCRIPTION INFORMATION

STEP 4 - ACCEPTANCE AND SUBMISSION

Please read the following statements carefully, as a claim will not be processed unless initials from the claimant / service advisor have been provided.

Please type your initials to indicate: I hereby certify that the above statements are complete and accurate to the best of my knowledge. I understand that any inaccurate information entered on this form could affect the outcome of the claim, including denial of claim.

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CONTACT US

Phone number

888-442-2886

Address

American Auto Guardian, Inc.
P.O. Box 925
Arlington Heights, IL. 60006-0925

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