INSURANCE AUTHORIZATION FORM

 

Blue Star Brothers Auto Collision Center

222 India Street Greenpoint, Brooklyn, NY 11222

INSURANCE AUTHORIZATION FORM

    INSURANCE AUTHORIZATION FORM





    Agreement; I hereby authorize BLUE STAR BROTHERS ENTERPRISE INC., and its employees to perform the needed repairs to
    my vehicle as well as permission to operate the vehicle here in described on streets, highways, or elsewhere for the purpose of
    testing/inspecting. Repairs include parts, labor, materials, and diagnostics. If on further inspections, additional parts or repairs
    are needed, you will be contacted for authorization. BLUE STAR BROTHERS ENTERPRISE INC. is not responsible for
    the availability or delay on parts beyond our control, or for the loss, or damage to the vehicle, or articles left in the vehicle in
    the case of a fire, theft, or any cause beyond our control.

    DIRECTION OF PAYMENT - BLUE STAR BROTHERS ENTERPRISE INC.
    TAX ID#: 82-5090229

    I do hereby appoint the aforementioned business to accept on my behalf any and all checks, drafts, bills of exchange, and to endorse all such checks, drafts, and bills of exchange for the deposit to the aforementioned business account for credit on my account for repairs on my vehicle which has been released and accepted.

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    Blue Star Brothers Auto Collision Center & Body Shop

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