Beverly METLIFE DTP
AUTHORIZATION TO REPAIR - DIRECTION TO PAY
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
Zip code: 01915
Federal Tax Identification Number (TIN): 042-694-666
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.