TONY'S AUTO BODY

Payment & Repair Authorization

Please complete each step and review both authorizations before signing.

1Claim & Vehicle
2Payment
3Repair
4Contact & Review
STEP 01

Claim & Vehicle Details

Enter the information shown on the current authorization form.

Insurance / Claim Information

Claim number can be left blank if it has not been issued yet.

Vehicle Information

STEP 02

Direction of Payment

Review the authorization below before adding the first vehicle-owner signature.

Vehicle Owner Signature

Direction of Payment

Sign here
By my signature, Authorize
STEP 03

Repair Authorization

Read the repair authorization carefully before signing.

Vehicle Owner Signature

Repair Authorization

Sign here
By my signature, Authorize
DATE
STEP 04

Contact Information & Review

Provide your preferred contact information, then review everything before submitting.

Contact Information

Please provide a cell phone number or email address. An alternate phone number is optional.

FINAL REVIEW

Check the details before submitting

Both signatures required
Vehicle owner—
Drop-off date—
Claim #Not provided
Authorized payer—
Vehicle—
Authorization date—
Direction of Payment signature
Direction of Payment signature preview
Repair Authorization signature
Repair Authorization signature preview