Beverly METLIFE DTP
Submit signed & completed form to MetLife Auto & Home as an attachment or as a digital photograph.
Original to be retained at shop and produced upon request.
Shop Name: Auto Body Clinic Inc. (978-922-3334), Address: 29 River Street, City: Beverly
State: MA, Zip code: 01915
Federal Tax Identification Number (TIN): 042-694-666, Claim Number:
Vehicle Owner Name: , Vehicle Owner Email: , Vehicle Year: , Vehicle Make: , Vehicle Model: , VIN:
I hereby authorize said facility to commence repairs upon my vehicle.
Furthermore, I authorize MetLife Auto & Home to issue any payment to the aforementioned facility and, mail said payment directly to this repair facility.
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If you have questions about the contents of this document, you can email the document owner.
Document Name: Beverly METLIFE DTP
Agree & Sign