Create a report

Claim form for CityHubs

Use the form below to report damage to vehicles or, for example, to buildings or equipment. 

Fields marked with * are required.

What type of damage do you want to report?
This is where the confirmation of the damage report is sent.

 
E.g.: 07-07-2020
E.g.: 13:44

 

 

Add documents 

Choose a file
One file only. 8 MB limit. Allowed types: doc, docx, pdf, jpg, jpeg, png.
Choose a file
One file only. 8 MB limit. Allowed types: doc, docx, pdf, jpg, jpeg, png.
Choose a file
One file only. 8 MB limit. Allowed types: doc, docx, pdf, jpg, jpeg, png.
Choose a file
One file only. 8 MB limit. Allowed types: doc, docx, pdf, jpg, jpeg, png.
Choose a file
One file only. 8 MB limit. Allowed types: doc, docx, pdf, jpg, jpeg, png.
Choose a file
One file only. 8 MB limit. Allowed types: doc, docx, pdf, jpg, jpeg, png.
Choose a file
One file only. 8 MB limit. Allowed types: doc, docx, pdf, jpg, jpeg, png.
Choose a file
One file only. 8 MB limit. Allowed types: doc, docx, pdf, jpg, jpeg, png.
Choose a file
One file only. 8 MB limit. Allowed types: doc, docx, pdf, jpg, jpeg, png.
Choose a file
One file only. 8 MB limit. Allowed types: doc, docx, pdf, jpg, jpeg, png.