Reimbursement Form | Lexus New Zealand

REIMBURSEMENT CLAIM FORM

Facilitate your claims reimbursement by filling in your details below and attaching all required documents.

CUSTOMER DETAILS

Please choose your salutation.

Full name

Please provide your full name.

Address line 1

Please provide a valid address.

Address line 2

Please provide a valid address.

Email address

Please provide a email address.

Please provide a valid email address.

Vehicle registration number

Please provide your vehicle registration number.

Current odometer reading km

Please provide current odometer reading.

RECOVERY & TOWING COSTS

Costs from towing your vehicle to an authorised Lexus Dealer.

Date of breakdown

Please provide date of breakdown.

Distance towed km

Please provide distance towed.

Location of breakdown

Please provide location of breakdown.

Lexus Dealer your vehicle was towed to

Please select your Lexus Dealer.

Nature of breakdown

$ Amount to be claimed

Please provide your vehicle delear.

Invoice

Upload invoice Add invoice +

RENTAL & ACCOMMODATION COSTS

RENTAL COSTS

Costs from renting a temporary vehicle during the repair of your Lexus.

Maximum value of $400 incl GST.

ACCOMMODATION COSTS

Costs from emergency accommodation arrangements made.

Maximum value of $450 incl GST.

Additional queries/comments (optional)

I acknowledge that the expenses described above have been paid for and are covered under my vehicle’s warranty.

Please agree to our terms and conditions.

Date

Please provide date acknowledged.

For any questions regarding your vehicle, please contact us at customercare@lexus.co.nz or call us on 0800 4 LEXUS

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LS

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RX

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LC

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IS 300h

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IS 300h Limited

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ES 300h

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ES 300h Limited

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RX 450h

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RX 450h Limited

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RX 450h F SPORT

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RX 450h L

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GS 450h Limited

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GS 450h F SPORT

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LC 500h

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NX 300h

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NX 300h Limited

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LS 500h

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UX 250h F Sport

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UX 250h AWD

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UX 250h Limited

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IS 350 F SPORT

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GS 350 F SPORT

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