direction to pay form



COMPLETING THE FORM BELOW allows payment from the insurance company to be issued directly to the shop. THIS is ALSO required so your vehicle may be released upon completion of repairs.

By signing this Form, YOU agree that your electronic signature is the legally binding equivalent to your handwritten signature. Whenever you execute an electronic signature, it has the same validity and meaning as your handwritten signature. you understand that your electronic signature is legally binding.

By signing below, you accept the conditions of this agreement.