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Request a Claim Form

Please complete the form below, and you will receive a separate email from the Claims Department with the Required TXDMV Claim Form, along with instructions on how to submit a claim.

"*" indicates required fields

* Do not discard any damaged items as our claims team may need to inspect.

** Any items repaired prior to the completion of the claims process, may result in claim being denied.

This field is for validation purposes and should be left unchanged.