Home
About
Vehicles
FAQ
Apply Now
Rental Rates
Contact
Home
About
Vehicles
FAQ
Apply Now
Rental Rates
Contact
1300 DAILY RENTAL RATES
(Phone 1300 668 693)
Hire car recovery form
[[[["field33","contains","No"]],[["show_fields","field48,field47,field46,field45,field9,field43,field65,field40,field41,field90"],["show_fields","field120"]],"and"],[[["field62","contains","No"]],[["show_fields","field89,field71,field70,field69,field68,field67,field66,field42,field64,field63"],["show_fields","field122"]],"and"]]
1
YOUR VEHICLE DETAILS
2
At fault DETAILS
3
DETAILS of accidents
Driver
Name
your full name
Address
your full name
Mobile Number
your full name
Business Phone
your full name
Home Phone
your full name
Fax
your full name
Drivers Licence
your full name
DOB
date of birth
Email
a valid email
Is the Registered Owner Also the Driver?
Is the registered owner also the driver?
pick one!
Select an Option
Yes
No
Registered Owner
Name
your full name
Address
your full name
Mobile Number
your full name
Business Phone
your full name
Home Phone
your full name
Fax
your full name
Drivers Licence
your full name
DOB
date of birth
Email
a valid email
Vehicle Details
Registration
your full name
Vehicle Make
your full name
Vehicle Model
your full name
Year
your full name
Policy Number
your full name
Claim Number
your full name
Owners Insurance Company
your full name
Smash Repair Details
Name
your full name
Date Hire Car Required
your full name
Driver at Fault
Name
your full name
Address
your full name
Mobile Number
your full name
Business Phone
your full name
Home Phone
your full name
Fax
your full name
Drivers Licence
your full name
DOB
date of birth
Email
a valid email
Is the Registered Owner Also the Driver?
Is the registered owner also the driver?
pick one!
Select an Option
Yes
No
Registered Owner
Name
your full name
Address
your full name
Mobile Number
your full name
Business Phone
your full name
Home Phone
your full name
Fax
your full name
Drivers Licence Number
your full name
DOB
date of birth
Email
a valid email
Vehicle Details
Registration
your full name
Vehicle Make
your full name
Vehicle Model
your full name
Year
your full name
Policy Number
your full name
Claim Number
your full name
Owners Insurance Company
your full name
Accident Details
Date of Accident
of appointment
Time
of appointment
00
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
00
30
Street
your full name
Suburb
your full name
Brief Description of Accident
more details
0
/
Witness Details
Name of Witness
your full name
Address of Witness
your full name
H/W Phone
your full name
Mobile
your full name
Who Admitted Liability to Accident
your full name
Declaration
I confirm that, to the best of my knowledge, the information I have provided is true, complete and correct;
I have read, understand and agree to Onyx's
Privacy Policy
which contains information about how you can access and correct your personal information, how to make a complaint, and how we deal with complaints; and
I have read and understood the
Agreement and Authority to Act & Terms and Conditions of Use.
Submit Form
Previous
Next
powered by FormCraft