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What is Diminished Value?
Do You Qualify?
The Diminished Value Claim Process
Georgia Diminished Value Claims
When Is A Vehicle Total Loss?
The Total Loss Claims Process
1st Party Claimant vs 3rd Party Claimant
The Appraisal Clause Process
At-Fault Party Has Minimal Coverage
Know Your Repair Rights
Our Services
Free Diminished Value Qualification Quiz
Free Diminished Value Claim Review
Diminished Value Appraisals
Total Loss Appraisals
Problem Claim Consultations
Expert Witness Court Testimony
Ins Co Assignment Form
About Us
Our Company
Vehicle Appraisals
Watch our TV Commercial
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Articles
Resources
State Insurance Departments
Coverage Explanations
Helpful Information
FAQs
Diminished Value FAQs
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Contact Us
Total Loss Vehicle Appraisal Order Form
Total Loss Vehicle Appraisal Order Form
Vehicle Owner Information
Name
*
Email Address
*
Primary Phone
*
Alternate Phone
Cell Phone
*
Home Address
*
Street Address
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
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Ohio
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Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Name of Your Insurance Company:
*
If other party at-fault, enter name of their Insurance company
Vehicle Inspection Location
Please provide us with the location where your vehicle can be inspected. Inspections are completed Monday – Friday between the hours of 8:00am and 5:00pm. Specific times are not given due to the uncertainty of traffic and other delays. You may select a day part.
Location:
*
Residence Address As Above
Body Shop / Salvage Yard
Salvage Yard Lot #
*
Name of Location:
*
Phone Number
*
Contact Name
*
Address
*
Street Address
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Vehicle Information
Year
*
Make
*
Model
*
Series/Package (i.e.: LS, ES, XLT, GL)
*
Color
*
# of Doors:
*
VIN Number:
*
Engine Size
*
# of Cylinders
3 Cylinder
4 Cylinder
5 Cylinder
6 Cylinder
8 Cylinder
10 Cylinder
12 Cylinder
Hidden
# Of Cylinders
*
Engine Type
*
Gas
Diesel
Gas/Electric Hybrid
Plug-In Electric
Hidden
Engine Type
*
Gas
Diesel
Hybrid
Turbo
Drive Train
*
2 Wheel Drive
4 Wheel Drive
All-Wheel Drive
Transmission
*
Automatic
Manual 3 Speed
Manual 4 Speed
Manual 5 Speed
Manual 6 Speed
Tiptronic
PDK
Hidden
Transmission
*
Automatic
Manual 3 Speed
Manual 4 Speed
Manual 5 Speed
Manual 6 Speed
Tiptronic
Mileage at time of Damage:
*
Date Of Current Damage/Collision:
*
Month
1
2
3
4
5
6
7
8
9
10
11
12
Day
1
2
3
4
5
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19
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23
24
25
26
27
28
29
30
31
Year
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Any Prior Collision?
*
No
Yes
(If Yes) Give Date
Month
1
2
3
4
5
6
7
8
9
10
11
12
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Pre-Damage Vehicle Condition:
*
Poor
Fair
Average
Above-Average
Excellent
Cost of Repairs $
If the vehicle is less than 1 year old, what was the purchase price $:
Cash Price Not including trade allowance, sales tax, warrantees or finance charges
Vehicle Options (Please check all that apply)
POWER ACC
Power Steering
Power Windows
Power Locks
Power Mirrors
Heated Mirrors
Cruise Control
Tilt Steering Whl
Telescope Str Whl
Rear Defroster
Air Conditioning
Dual Air Cond
Climate Control
Dual Zone A/C
Anti-Lock Brakes
Anti-Lock Rear
Driver Airbag
Dual Airbags
Side Airbags
Head Airbags
Rear Side Airbags
Rear Wiper
Remote Trunk Rls
Limited Slip Diff
Locking Diff
Elec. Stability Cntrl
Xenon Headlamps
RADIOS/ALARMS
AM Radio (AM)
AM/FM Stereo
AM/FM Tape
AM/FM Cass/CD
CD Player
CD Changer
InDsh Changer
MP3 Player
Removed
Alarm System
Phone
Remote Starter
Keyless Entry
OnStar
Navigation Sys
Tachometer
Center Console
Overhed Cnsole
Lighted Entry
Rear Entertnmnt
Front Entertnmnt
MP3 Player
Reverse Sensing
Parking Assist
Satellite Radio
SEATS
Power Seat
Dual Pwr Seats
Heated Seats
Htd F&R Seats
Split Bench
Bucket
Cloth/Velour
Leather
Vinyl
2 Captain Chairs
4 Captain Chairs
6 Captain Chairs
2nd Row Capts
2nd Row Bckts
3rd Row Seating
PAINT/TRM/GLASS
Two-Tone
Special Paint
Metallic Paint
Graphics
Tinted Glass
Tinted A/M
Privacy Glass
Sunscreen Glass
Rear Spoiler
ROOF
Landau Roof
Hard top
Luggage Rack
Roll/Light Bar
Pwr Conv Top
Soft Top
SUNROOF
Pwr Solid Sunroof
Manual Solid Snrf
Pwr Glass Mnroof
Pop-Up Roof
T-Top Glass
T-Top Solid
Dual Sunroofs
PICKUP TRUCK/VAN
4x4
Standard Cab
Extra Cab
Crew Cab
Flare Side
Fleet Side
Stepside
Bed Size
Dual Slding Drs
Pwr Sld RH Door
Pwr Sld LH Door
Ladder
Bed Size
Please specify bed size below
BUMPERS
Rear Stp Bumper
Tubular Bumper
Chrome Bumpers
Chrome Stp Bmpr
WHEELS/TIRES
Wire Wheels
Wire Wheel Cvrs
OE Aloy Wheels
AM Alloy Wheels
Chrome OEM
Chrome A/M
Styled Steel
Manual Lock
Wide Tires
Dual Rear Whls
5th Wheel
Trailer/Camper
Trailer Hitch
Running Boards
Spare Tire Carier
Side Steps
Tubular Side Steps
Tonneau Cover
Hrd Tonneau Cvr
OTHER
Grill Guard
Fog Lights
Winch
Canopy
Camper Shell
Bedliner
SprayOn Bedliner
Tool Box
Extra Tank
Hydraulic Liftgate
Lift Kit
Ground Eff. Pkg
Lowered
Sld Rear Window
Pwr Sld Rear Wnd
Bra
Air Dam
Rear Heater
Bug Shield
Custom Exhaust
Mini Blinds
Lojack System
Rack Cross Bars
Rear Wnd Dflctr
Lift Kit (
Please specify size in inches below
Lowered
Please specify size below
Notes
Additional Information
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Home
Info Center
What is Diminished Value?
Do You Qualify?
The Diminished Value Claim Process
Georgia Diminished Value Claims
When Is A Vehicle Total Loss?
The Total Loss Claims Process
1st Party Claimant vs 3rd Party Claimant
The Appraisal Clause Process
At-Fault Party Has Minimal Coverage
Know Your Repair Rights
Our Services
Free Diminished Value Qualification Quiz
Free Diminished Value Claim Review
Diminished Value Appraisals
Total Loss Appraisals
Problem Claim Consultations
Expert Witness Court Testimony
Ins Co Assignment Form
About Us
Our Company
Vehicle Appraisals
Watch our TV Commercial
Our Radio Commercial
Testimonials
Our References
Articles
Resources
State Insurance Departments
Coverage Explanations
Helpful Information
FAQs
Diminished Value FAQs
Total Loss FAQs
Contact Us