SATISFACTION NOTE
By filling out this form, you consent to have your feedback, including your name, published across our public channels.
NAME AND DETAILS OF THE ASSURED:
Enter Email (*)
Enter Claims Number (*)
Enter
Title (*) Mr.Mrs.Ms.Others
Surname (*)
First Name (*)
Middle Name
Policy Number (*)
Date of Car Delivery (*)
VEHICLE DETAILS:
Make: (*)
Model: (*)
Registration Number: (*)
Select Garage (*) AGBONMAGBE AUTOMOBILES & AUTOMOTIVE LTD. No. 4 Aje Street, Sabo Yaba, Lagos. 08069126260/08023361802GUARDIAN AUTOS 18/33 Brickfield Road, Ebute Metta, Surulere Lagos. 08023010881AUTO PERFECTION (PORT-HARCOURT) 2 Professor Abowei GRA port Harcourt, River state. 08033166136/08038750111FALAS AUTOS Km 44, Lagos Ibadan Expressway, Lotto Bus-Stop, Mowe, Ogun State. 08027979335/08062520708
On a scale of 1 to 7. Please rate your satisfaction with the claims process: (*)
Very Difficult 1
Not Easy2
Not So Easy 3
Not Sure 4
Somewhat Easy5
Easy 6
Very Easy 7
Please give reasons behind your score: (*)
I/We declare that the repair/damage to my/our vehicle with details above upon reporting the accident which occurred on or about the above date of loss and which was the subject of the above claim number has been carried out satisfactorily by the Workshop stated above and that I/We do not have any further claims against the company in respect of the said accident and that the payment of the repairer's bill shall constitute a full discharge of my/own claim for such a damage.
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Signed Date: (*)
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