GGI Claim Submission Form

Claim #*

Damage Report, Repair or Salvage?*

Damage Report
Salvage

First Name*

Last Name*

Phone Number*

You can add more than one number if needed. Put “0” if we should contact via email only

Email Address

Address on File / Confirm with Client*

We will provide the risk address we have on file
Please confirm risk address with the client

Risk Address*

Please add your address. Collection notes can be added in the “Damage / Problems Experienced / Notes” field if needed: Eg: Please hoot at the gate, intercom broken.

Street Address Address Line 2 City

Additional Contact Information:

Insured Value

Excess Amount

Type of Device

Device Make

Apple
Samsung
Huawei

Device Model

IMEI Number

Device Capacity

Colour

Passcode/Pattern

We will need to be able to thoroughly test your phone after repairs, to ensure everything works perfectly. In order to do this, we need to be able to access the phone’s functions. You can either wipe all the data off your phone and reset it to factory settings (with no iCloud or other locks on it) or you can provide us with your passcode or pattern. Your phone will only be accessed for testing – no apps will be opened and your data will remain safe at all times. To send us a pattern code, you can use the diagram below to describe the pattern.

Damage / Problems Experienced / Notes:

Platinum Repairs: Trustworthy Tech Repairs In South Africa

GGI Claim Submission Form

GGI Engineering Claim Submission Form