Tire Defects Contact Form

Name

Email Address

Phone Number

Please describe briefly the accident involving the tire.

What company manufactured the tire?

On what make and model of vehicle was the tire mounted?

What was the date and time of the accident?

What were the driving conditions?

How many people were in the vehicle during the accident?

Was anyone injured during the accident?
Yes  No 

Please describe briefly the injuries.

Do you have a police report, photographs, or other evidence?
Yes  No 

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