ALFA Insurance Repair Authorization

ALFA Insurance Repair Authorization
Name

First NameLast Name
Cell Phone Number
Please enter a valid phone number.
Email
example@example.com
Please read the following repair authorization form and sign at the bottom. By signing I agree that I have read and agree to abide by the guidelines in this document.
1. I authorize Highway 280 Paint and Body to repair my vehicle.
2. A signed Direction to Pay is due upon delivery of my vehicle.
3. The deductible amount is due upon delivery of my vehicle.
4. Debit/Credit cards will be charged a 3% convenience fee.
Signature

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