GAP PROFESSIONAL PRODUCTS LIFETIME PROTECTION PROGRAM CLAIM FORM

    CUSTOMER (Enter Your Info Below)

    State/Province*

    VEHICLE (Enter Your Vehicle Info Below)

    CLAIM (Enter Your Claim Info Below)

    Vehicle System*

    Please attach full statement of damage or diagnostic report for claim. (File Types Accepted: JPG, JPEG, PNG, PDF)

    Please attach service history, estimates and all supporting documents related to this claim. (File Types Accepted: JPG, JPEG, PNG, PDF)

    DEALER (Enter Your Dealership Info Below)

    Dealer State/Province*