Body Shop Request Form 

Contact Information

* First Name: * Last Name:
* Email: * Home Phone:
* Day Phone: Fax:
Cell Phone: * Preferred Contact:
* Address:
* City: * State: * ZIP Code:
Survey Questions
*What is the name of the insurance company (own, other driver, etc)?
*What is the make and model of the vehicle?
*Interested in using our mobile estimating?
Yes No
*Do you have a claim number? If yes, please fill in the box below.
Yes No
*Where is the vehicle now?
*Brief description of the damages.
* These fields are required
Lochmandy Motors
920 North Nappanee Street
Elkhart, IN 46514
Site Map
Toll Free: 800-873-1341
Email: Contact Us
Fax: (574) 264-0831