CertiMotive© Hail Scope Sheet

CertiMotive© Hail Scope Sheet
Date

MonthDayYear
Date
Hour MinutesAM/PM Option
CertiMotive© ID#*
ID# must be Input to use this Form
Appraisers First Name*
Appraisers Last Name*
Appraisers Email*
example@example.com
Claim #*
IA Co File #
Ins Co*
If Other, List Here
Vehicle Year*
Vehicle Make*
Vehicle Model*
If Pre-1995, list Year here
Mileage (Odometer - NOT KM)*

Other Note for Add Ons
R&I (AIAG Codes List)

Antenna/Antenna BaseBattery/BoxBumper/Cover/Ext-FrontBumper/Cover/Ext-RearBumper Guard/Strip-FrontBumper Guard/Strip-RearDoor-Back Cargo, RightDoor-Back Cargo, LeftDoor-Right CargoDoor-Left FrontDoor-Left Front Emblems/MldgsDoor-Left RearDoor-Left Rear MldgsDoor-Right FrontDoor-Right Front Emblems/MldgsDoor-Right RearDoor-Right Rear MldgsFender-Left FrontFender-Left Front Emblems/Mldgs/FlareQuarter Panel/Pick-Up Box LeftQuarter Panel/Pick-Up Box Left Emblems/Mldgs/FlareFender-Right FrontFender-Right Front Emblems/Mldgs/FlareQuarter Panel/Pick-Up Box - RightQuarter Panel/Pick-Up Box - Right Emblems/Mldgs/FlareFront Floor MatsFloor Mats RearGlass WindshieldGlass RearGrilleAccessory Bag/BoxHeadlight/Cover/Turn SignalLamps-Fog/Driving/Spot LightHeadlinerHoodHood InsulatorHood SealKeysKeyless RemoteMirror-Outside LeftMirror-Outside RightAudio/Video PlayerTV/DVD ScreenRocker Panel/Outer Sill - LeftRocker Panel/Outer Sill - RightRoofRunning Board/Step - LeftRunning Board/Step - RightSpare Tire/WheelSplash Panel/Spoiler - FrontGas TankTail Light/HardwareTrim Panel-Front LeftCD Changer Separate UnitTrim Panel-Front RightDeck Lid/Tailgate/HatchbackSunroof/T-TopUndercarriage-OtherCargo Area-OtherVinyl/Convertible Top/Tonneau CoverWheel Covers/Caps/RingsRadio SpeakersWipers, allBox Interior, PickupRails, Truckbed/LightbarSpoiler/Deflector-RearLuggage Rack (Strips Drip Rail)Dash/Instrument PanelCigarette Lighter/AshtrayCarpet-FrontCenter Post, RightCenter Post LeftCorner PostLeft Front TireLeft Front Wheel/RimLeft Rear TireLeft Rear Wheel/RimRight Rear TireRight Rear Wheel/RimRight Front TireRight Front Wheel/RimCowlGas/Cap CoverFender-Rear LeftFender-Rear RightTools/Jacks/Spare-Tire Mount + LockCommunication/GPS UnitParking Sonar SystemTrailer Hitch, Wiring Harness, Tow HooksFrameExhaust SystemLicense-BracketSteering Wheel/AirbagSeat-Front LeftSeat-Front RightSeat-RearCarpet-RearInterior-OtherEngine Compartment-OtherOther
R&I Notes & "Other":
Replace (AIAG Code List)

Antenna/Antenna BaseBattery/BoxBumper/Cover/Ext-FrontBumper/Cover/Ext-RearBumper Guard/Strip-FrontBumper Guard/Strip-RearDoor-Back Cargo, RightDoor-Back Cargo, LeftDoor-Right CargoDoor-Left FrontDoor-Left Front Emblems/MldgsDoor-Left RearDoor-Left Rear MldgsDoor-Right FrontDoor-Right Front Emblems/MldgsDoor-Right RearDoor-Right Rear MldgsFender-Left FrontFender-Left Front Emblems/Mldgs/FlareQuarter Panel/Pick-Up Box LeftQuarter Panel/Pick-Up Box Left Emblems/Mldgs/FlareFender-Right FrontFender-Right Front Emblems/Mldgs/FlareQuarter Panel/Pick-Up Box - RightQuarter Panel/Pick-Up Box - Right Emblems/Mldgs/FlareFront Floor MatsFloor Mats RearGlass WindshieldGlass RearGrilleAccessory Bag/BoxHeadlight/Cover/Turn SignalLamps-Fog/Driving/Spot LightHeadlinerHoodHood InsulatorHood SealKeysKeyless RemoteMirror-Outside LeftMirror-Outside RightAudio/Video PlayerTV/DVD ScreenRocker Panel/Outer Sill - LeftRocker Panel/Outer Sill - RightRoofRunning Board/Step - LeftRunning Board/Step - RightSpare Tire/WheelSplash Panel/Spoiler - FrontGas TankTail Light/HardwareTrim Panel-Front LeftCD Changer Separate UnitTrim Panel-Front RightDeck Lid/Tailgate/HatchbackSunroof/T-TopUndercarriage-OtherCargo Area-OtherVinyl/Convertible Top/Tonneau CoverWheel Covers/Caps/RingsRadio SpeakersWipers, allBox Interior, PickupRails, Truckbed/LightbarSpoiler/Deflector-RearLuggage Rack (Strips Drip Rail)Dash/Instrument PanelCigarette Lighter/AshtrayCarpet-FrontCenter Post, RightCenter Post LeftCorner PostLeft Front TireLeft Front Wheel/RimLeft Rear TireLeft Rear Wheel/RimRight Rear TireRight Rear Wheel/RimRight Front TireRight Front Wheel/RimCowlGas/Cap CoverFender-Rear LeftFender-Rear RightTools/Jacks/Spare-Tire Mount + LockCommunication/GPS UnitParking Sonar SystemTrailer Hitch, Wiring Harness, Tow HooksFrameExhaust SystemLicense-BracketSteering Wheel/AirbagSeat-Front LeftSeat-Front RightSeat-RearCarpet-RearInterior-OtherEngine Compartment-OtherOther
Replace Notes & "Other":
Add'l Notes:
Should be Empty:

	1-5 Dents D N Q H CR	6-15 Dents D N Q H CR	16-30 Dents D N Q H CR	31-50 Dents D N Q H CR	51-75 Dents D N Q H CR
Hood
Roof
Decklid/Liftgate
L Fender
L FT DR
L RR DR
L Qtr
L Rail/Uniside
R Fender
R FT DR
R RR DR
R Qtr
R Rail/Uniside

	76-100 Dents D N Q H CR	101-150 Dents D N Q H CR	151-200 Dents D N Q H CR	201-300 Dents D N Q H CR
Hood
Roof
Decklid/Liftgate

	OS - Amount
Hood
Roof
Decklid/Liftgate
L Fender
L FT DR
L RR DR
L Qtr
L Rail/Uniside
R Fender
R FT DR
R RR DR
R Qtr
R Rail/Uniside

	Alum	HSS	Glue Pull	Other - Note below
Hood
Roof
Decklid/Liftgate
L Fender
L FT DR
L RR DR
L Qtr
L Rail/Uniside
R Fender
R FT DR
R RR DR
R Qtr
R Rail/Uniside