01.11.2017 » Due to technical issues please send any/all email correspondence to : europa.claims@outlook.com
Contact Information
Address: Europa Consultants Ltd, Europa House, Barcroft Street, Bury, Lancashire. BL9 5BT E-mail: Telephone: 01706 661 723 Fax: 01706 661 723

Make a claim

Thursday 17th October

	Title:
	Name:
	Address:
	Postcode:
	Telephone:
	Mobile:
	Email:
	Bodyshop referrer (if applicable) :
	Vehicle Make & model:
	Vehicle Reg.:
	Driveable:		Yes No

	Third party Name:
	Address:
	Telephone:
	Insurer:
	Policy No.:
	Vehicle Make & Model:
	Vehicle Reg:
	Colour:

	Were there any witnesses:		Yes No
	Was anybody injured:		Yes No
	Accident circumstances:
	Accident date (dd/mm/yyyy):

			Fields marked with * are mandatory.