Guaranteed Maintenance Referral

This referral form is to be completed by the vehicle finance provider, broker or motor dealer.

You must obtain full permission from the customer before referring their details over to Autoserve.
An Autoserve representative will in contact with your client by both phone and email to discuss Guaranteed Maintenance.
Only complete this form is your client is happy to be contacted.

Your Details / Referrer Details:

Name of your company branch

Your Client's Details:

Vehicle details:

e.g. (1+23)