Repair Authorization

WILLIAMS PAINT AND BODY SHOP

REPAIR AUTHORIZATION & DIRECTION TO PAY

Dear Valued Customer :

Thank you for choosing Williams Paint and Body Shop to repair your vehicle. This Repair Authorization states the terms under which Williams Paint and Body Shop will repair your damaged vehicle. We are happy to answer any questions you may have, and our goal is to ensure your complete satisfaction. Thank you for choosing us!

First name

Last name

Date Signed

Cell Phone

Yes, sign me up for repair status updates via text message.

Alt. Phone

Multi-line address

Country/Region

Address

City

Zip / Postal code

Vehicle Year

Vehicle Make

Vehicle Model

Vehicle Color

Insurance Company

Deductible Amount

Claim Number

Message to Shop (Not Required)

File upload

If an estimate was provided by your insurance company, please upload here.