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

City: Beverly

State: MA

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.