Motor theft claim form Please enable JavaScript in your browser to complete this form.Policy NumberID No./Reg No *Identity Number/Company Registration NumberNameContact NumberNextVehicle Details Vehicle MakeBMW, FordVehicle ModelEg. 320i, RangerYear of ManufactureVehicle Registration NumberVehicle Kilometres CompletedVehicle Identification Number (VIN)Theft Details Date of TheftDD12345678910111213141516171819202122232425262728293031MM123456789101112YYYY20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Time of Theft Place of TheftPlease Be Accurate As Possible, Eg. Street Address, Shopping Mall Name SAPS Station Reported AtSAPS Reference NumberDate ReportedDD12345678910111213141516171819202122232425262728293031MM123456789101112YYYY20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Reported ByName Of Person Was The Vehicle Locked *YesNoPlease ExplainReason Vehicle Was Not Locked PreviousNextNumber of Stolen Accessories012345Description of Item 1Description of Item 2Description of Item 3Description of Item 4Description of Item 5Are These Separately InsuredYesNoPlease Attach Invoices Click or drag files to this area to upload. You can upload up to 5 files. Please Attach Invoices of Stolen Accessories Details of Scratches, Dents, or DefectsIdentifiable Defects on VehicleDetails of Other Features Which Will Help With IdentificationEg. Stickers, I/We hereby declare the foregoing particulars to be true in every respect. In terms of the policy, I/We agree to render all assistance requested by the Insurer and the identification and physical recovery of such vehicle to be located *I AgreeSignature Clear Signature PreviousSubmit Quick Links Products About Us Get a Quote Claims Download/Submit Forms Claim Online Contact Us Contact Us (031) 336 9400 info@wwib.co.za Santoni House Westwood Insurance Brokers (Pty) Ltd is an authorised financial services provider | FSP No.: 16726 Linkedin