Tire Protection Plan

Tire Protection Plan

Claim Form
We value your business and aim to make this process quick and easy.

Claims will be reviewed within 5 business days. We may call or email you for more information.

Need help? Call us at 512-918-2345 (Mon - Fri 9am - 6pm CT). Outside of business hours or away from the Austin area? Email tpp@tridentatx.com.

Note: You should keep the damaged tire(s) until the claim is settled.
Full Name*

First NameLast NameSuffix
Phone Number*
E-mail*
Date of Incident*

MonthDayYear
Type of Reimbursement(s) Requested*

Tire Repair (Patch)Tire ReplacementRoadside AssistanceTowing
Location of Incident*
Where were you when the damage occurred (or when you first noticed it)?
Statement*
Please explain how the damage occurred and the nature of the damage. If you are unsure, state how the damage was first noticed and the nature of the damage.
Did You Retain The Damaged Tire(s)?*

YesNo
Preferred Method of Reimbursement*

Check By MailPayPal
Reimbursement Address*
For reimbursement by PayPal, provide your username. For reimbursement by check, provide the payee's name and current mailing address. Note: The Payee's name should match the customer's name listed on the TPP Agreement (changes permitted to replace nicknames).
Upload Documentation

Please upload a copy of all invoices for which you are claiming reimbursement, as well as photos clearly showing damage to the tire(s). Need to submit more files? Email tpp@tridentatx.com.
Cancelof
Comments (optional)
The information I have provided is truthful and accurate to the best of my knowledge.*

Powered by Jotform SignClear
Should be Empty: