Additional Information
All part and service references provided in this Technical Bulletin are subject to change and/or removal.
Always check with your Parts Dept. and Repair Manuals for the latest information.

Document Control Revision Table
Instance Number

Published Date

Version Number

Reason For Update

2039212/4

6/13/16

V581603

To update Claim
Processing statement.

2039212/3

7/21/15

V581503

To update service number.

2039212/1

12/17/14

V581403

Original publication.

Page 9 of 9 Plus attachments
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Paint/Corrosion Claim Form

400000

Dealer No.
Repair
Order No.

910000

VIN (17-Digits)

XXXXXXXXXXXXXXXXX

Color No. (4-digit ElsaPro Paint No.)

LR9A

Dealer Labor Rate

If repeat repair, provide explanation in box below:

100.00

Paint material price per unit

Service No.

Damage
Code

Dmg
Loc

Part manufacturer
(Vendor Code)

5829

0003

160

160

12.00

Dealer-owned paint shop?

Yes

Original paint material?

Yes

Description of Repair

Paint Rear Door

Paint Labor Operation(s)

No
No
Time
Units

Mat'l
Units

58517903

110

51017133

190

7

Verify ALL Labor Operation Time Units
and Material Units

If multiple doors are affected, the prep time
should be entered on the first line of the
SAGA claim and only once on the first
Paint/Corrosion Claim Form

Note: Authorization and claim reimbursement are contingent on the usage of original
parts for the repair

Body Painting Prep Time

The vehicle history must be checked for any previous damage. Digital photographs must be included with the repair order per VWoA instructions. If there is a
sublet invoice for painting, the invoice amount must be split between outside (sublet) labor and outside (sublet) material.

Part Number

Part Description

EPOXY

Part Qty

Epoxy Primer

Part Price
per Unit

1 $

Total Part
Price

40.00

Example Part Qty and Part Price per Unit only

Description of Repair

70731900

40

Remove and install door carrier unit

58301950

50

Remove and install rear door parts

58516500

50

Repair door (Remove Corrosion)

58516300

70

Wax Body

51017550

10

Bond trim strip with butyl

66414199

10

Example Time Units

Part Amount Subtotal

$

40.00

Body Labor Subtotal

230

Total Paint Material Amount

$

84.00

Total TU/MU

530

Total Parts Amount

$

124.00

VW Representative
Authorization No.

Authorization Date

TB 2039212
Authorization
valid until:

Warranty
VW Representative Name (printed)

7

Time
Units

Remove and install rear door trim

Full pre-populated forms can be found in the
following location:
WISE > Resource Center > Forms > Paint/
Corrosion > TB# - Form specific to the vehicle
and the repair.

Outside Material

Repair/Replace Labor
Operation(s)

300

for painting

All other parts should be claimed separately in
the SAGA claim

LACKMATF

Paint Subtotal

VW Representative Signature

7

L00#0000 $

300.00

A0041000 $

230.00

Parts and Materials: $

124.00

Total: $

654.00

Paint/Corrosion Claim Form

Dealer No.

400000

Repair
Order No.

910000

VIN (17-Digits)

XXXXXXXXXXXXXXXXX

Color No. (4-digit ElsaPro Paint No.)

LR9A
100.00

Dealer Labor Rate

If repeat repair, provide explanation in box below:

Paint material price per unit

Service No.

Damage
Code

Dmg
Loc

Part manufacturer
(Vendor Code)

5829

0003

160

160

12.00

Dealer-owned paint shop?

Yes

Original paint material?

Yes

Description of Repair

Paint New Rear Door

Paint Labor Operation(s)

No
No
Time
Units

Mat'l
Units

58516150

130

51017153

160

12

Verify ALL Labor Operation Time Units
and Material Units

If multiple doors are affected, the prep time
should be entered on the first line of the
SAGA claim and only once on the first
Paint/Corrosion Claim Form

Note: Authorization and claim reimbursement are contingent on the usage of original
parts for the repair

Body Painting Prep Time

The vehicle history must be checked for any previous damage. Digital photographs must be included with the repair order per VWoA instructions. If there is a
sublet invoice for painting, the invoice amount must be split between outside (sublet) labor and outside (sublet) material.

Part Number

Part Description

Part Qty

Part Price
per Unit

Total Part
Price

Description of Repair

Paint Subtotal

Repair/Replace Labor
Operation(s)

290

12

Time
Units

Remove and install rear door