Ethos Group Claims

Fabric Claim Request Form

Fields marked '*' are required. Providing detailed claim information and uploading the Repair Order (RO) enables us to more efficiently review and process payment for this claim. We pay up to MSRP on part price and determine labor by referencing any national, publicized labor guide. Filing this form does not imply that repairs are covered! Once the form is submitted we will review and respond back with either approval or request for additional information.

Customer's Full Name *

VIN *

Repair Facility Name *

Contact/Advisor Name *

Street Address *

City *

State *

Postal Code *

Contact/Advisor Email *

Used for follow-up communication and to receive claim approvals

Repair Facility Phone Number *

RO Date *

RO Number

Invoice or Work Order Number work as well

Current Mileage *

miles

Labor Guide

Hourly Labor Rate (if applicable)

Sales Tax Rate (if applicable)

Fabric Stain Removal

The customer is required to take care of the general cleaning of their interior. This program is for stains that can't be removed by the customer!

What is the reason for repair?

Total price for stain removal (including supplies and labor)

Pictures of damage required before stain removal will be approved. You can upload at the bottom of this form.

For all claims, the Completed Repair Order Signed by Contract Holder is required for payment.
For non-mechanical repairs, documentation of proof of damage is required.

Drag and drop or Browse
Only jpeg, png, and pdf formats
Up to 5 files at 4 MB per file