AUTO INSPECTION & PHOTOGRAPH REPORT
Vehicles bound with PHYSICAL DAMAGE coverage must be inspected and photographed.
Vehicles with EXISTING DAMAGE may not be bound (other than normal wear & tear disclosed below)
Policy Number: RGA2169558 Inspection Date: Inspection Time:
Insured Name: ALBA ELIET TORREZ GALEANO
Street Address: 580 SHINEY BROOK LN
City, State, Zip: LAWRENCEVILLE, GA 30044-6632
Year Make Model Vehicle Identification Number or VIN
2014 Kia Sorento 5XYKW4A7XEG457572
Odometer Reading: License Plate #: License State:
PHYSICAL CONDITION OF VEHICLE
Please check damaged areas or areas in poor condition (ex. dents, scratches and rust). Give particular attention to bumpers, windshields and condition of paint.
Please provide a written description of any damage.
Body Glass
Describe items checked above and any other damage:
PHOTOGRAPHS
Two photographs showing front and side, and rear and side, with license plate, are required in addition to the above inspection. Please maintain either a hard
copy of the photos in the insured's file or, if taken digitally, they can be stored on your hard drive.
INSPECTION IS NOT NEEDED WHEN:
• A new, unused vehicle is purchased from a licensed dealer or leasing company, if we are provided with: (1) a copy of the bill of sale or buyer's order
containing a full description of the vehicle including all options and accessories; or (2) a copy of the title/registration showing transfer of ownership
and a copy of the window sticker/dealer invoice with all options listed.
• A vehicle is leased for less than 6 months, if we receive the lease or rental agreement with a description of the leased vehicle, including its physical
condition.
The undersigned certifies that this Auto Inspection Report is true and also attests to the authenticity of the VIN.
Person presenting vehicle Signature Relationship to Insured
Inspector's/Agent's Name Inspector's/Agent's Signature
P O Box 723128 * Atlanta, GA * 31139-0128 * Phone: (888) 925-2902 * Fax: (877) 952-0258 * [Link]
AAINS (11/2017)