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Service Contracts
Veritas Select
Veritas Electric
Veritas Essentials
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Refer a Dealership
Decline VSC eForm
Submit “Second Chance” Lead
Order Materials
Start a Veritas Claim
Cancellation PDFs
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Veritas GAP Cancellation
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Decline Protection Products
"
*
" indicates required fields
Step
1
of
3
33%
Dealer Screen 1 of 2
The info we gather here will populate a "decline warranty" .pdf, which will be automatically emailed to you for your records. In addition, we'll gather customer consent for future offers.
Dealership
*
Dealer Representative
*
First
Last
Email
*
Phone
*
Hidden
Customer showed most interest in the following program:
Hidden
Program Name
*
Select
Guard
Essentials
Other
Hidden
Program Term in Months
*
Three
12
24
36
48
60 +
Hidden
Quoted Cost
Please enter a number from
100
to
9000
.
Hidden
Estimated Monthly Cost In Loan
Please enter a number from
5
to
100
.
Dealer Screen 2 of 2
Customer and vehicle information. Dealer representative should complete this section
Customer Name
*
First
Last
Phone
*
Email
*
VIN
*
Odometer
*
Customer Screen 1 of 1: Declining Available Protection Products
Please review carefully
Decline Available Service Contract
*
Decline
By signing below, I understand and acknowledge that I have been offered the option to purchase a Vehicle Service Contract.
Upon careful consideration, I have decided to DECLINE an available Vehicle Service Contract, and I understand that I am assuming all repair costs associated with owning the vehicle.
Additionally, I am buying the vehicle "As Is" and release the dealer from any future liability.
Typical Replacement Costs:
Engine $6,000-$10,000
Transmission $4,000 - $8,000
Alternator $750
Front Drive Axle $600
Starter $800
Fuel Pump $900
Water Pump $1000
ECM (computer) $1,500-$3,000
Sign & Date
Customer Signature
Date
*
MM slash DD slash YYYY
Last Chance - Decline the Service Contract:
*
Yes, decline the service contract
Receive vehicle specific insights & special offers from us and our partners
*
Yes please! 🤝
No thanks 🙁
No spam, only carefully curated material make the cut.
