Auto Glass Claim – Tartan Insurance Agency, Inc.

Fields marked with * are required

Your Name *

Your Email *

Phone Number *

Policy Number *

Date of Claim *

Vehicle Year *

Vehicle Make & Model *

Which Glass is Damaged (Select all that Apply)

Front Windshield
Rear Windshield
Driver-Side Front Window
Passenger-Side Front Window
Driver-Side Rear Window
Passenger-Side Rear Window
Vent Window (Small Door Window)
Sun Roof
Other

Please Describe how the Damage Happened *