Rental Car Request Form - Go Rentals

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  • What is your first name?
  • What is your last name?
  • What is your email address?
  • What is your phone number?
  • What is the year, make and model of the car that was damaged?
    YearMakeModel
  • What is the name of the body shop where your car is being repaired?
  • What is the name of your contact at the body shop?
  • What is the phone number for the body shop?
  • What is the address of the body shop?
  • Please enter your claim adjuster's name.
  • What is the claim adjusters phone number?
  • What is the claim adjuster's email address?
  • Please enter your claim number, if known.
  • Please enter the coverage amount you have available for a rental car.

  • Documents and Comments

  • Please use this field to upload any relevant documents.
    Drop files here or
    Max. file size: 128 MB, Max. files: 10.
    • Please enter any additional remarks in the space below.
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    Hellen Hill

    Hellen joined the Avery team in the summer of 2022 as a risk specialist in the commercial division of the agency. Prior to joining Avery, Hellen worked for many years as a commercial lines manager servicing large, complicated accounts. She took a break from her insurance career to earn her Master’s Degree in Education from Franklin Peirce University. After a stint in teaching, she decided to return to her roots and is happy to be back in insurance. Hellen hails from Concord, NH but recently relocated to Tampa, FL with her son.

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