Please submit your information below, and an Alloy Wheel Repair Specialist will contact you shortly.

*Name:            *Car Make: 

*Date:             * Car Model:

*Email:            * Car Year:  

*Phone:           *City:          

*State:             * Zip:          

*Wheel Size:                 

Hollander # (if known): 

City:       

County: 

State:    

Zip:        

Spoke Count:                 

Type of Wheel (check all that apply)

Machined      Polished      Painted

Chrome         Factory       Aftermarket Chrome

Additional Information:

Please email a photo of the wheel you would like to replace to claims@awrswheelrepair.com and reference your name in the email.