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Authorization
Authorization to Repair
Please read through our
Authorization to Repair
document, then fill out the online form below it.
Online Authorization
Vehicle Information
*
Indicates required field
Year
*
Make
*
Model
*
Contact Information
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Email
*
Phone Number
*
Authorization
Name
*
First
Last
Date
*
I have read and agree to the "authorization to repair" document
*
Yes, I have read the authorzation
Signature
*
I authorize this to be used as my signature
Submit
Home
Contact Us
Paint & Body
Insurance Information