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Device Damaged
Multiticket Form
Enter DRID Serial VRN
(separated by comma. 2nd line for next ticket)
Ticket Type
Your Name *
Your Email *
Your Phone Number *
Vehicle Location *
Ticket Type *
VRN *
DRID
Product Type
Forward Facing
Side Camera
Monitor
DVR
Other
Description of issue? *
Is the Vehicle in Use?
Yes
No
Are there any lights on the device?
Yes
No
If Yes please Describe what kind of lights are on
Was the damage done by 3rd party?
Yes
No
If Yes please describe 3rd party details
Image File Attachment(s)
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