Car Rental Windshield & Glass Damage Report
Date
Time
Location
Rental Agency
Rental Contract No.
Vehicle Make & Model
License Plate
Odometer Reading
Damage Details
Windshield / Glass Affected
Front Windshield
Rear Windshield
Left Front Window
Right Front Window
Left Rear Window
Right Rear Window
Sunroof / Moonroof
Other
Type of Damage
Chip
Crack
Scratch
Shatter
Other
Size of Damage
Description of Damage
Suspected Cause of Damage
Reported to (Staff Name, Position)
Immediate Action Taken
Signatures
Rental Staff Signature
Customer Signature
Date