Repair Authorization Form | Mayers Collision Center

Vehicle Owners Name*
First Last
Vehicle Make*
Vehicle Model*
Vehicle Year*
Insurance Company*
Claim Number*
Consent*
I agree to the repair authorization.
I authorize Mayer's Collision Center INC to estimate and repair my vehicle unless it is an economical total loss. I further understand that by signing this Repair Authorization, parts will be ordered for my scheduled repair date. Any cancellation of a scheduled appointment date may result in a restocking fee.
Signature
Date*
MM slash DD slash YYYY

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Saturday	9 AM - 1 PM