form download
Credit Card Authorization
Use this form to FAX us information to pay for a repair without coming in. All credit or debit card transactions must be swiped, inserted or have proof of authorization, making this form necessary for remote payment.
Please note: This form does not substitute a real credit card. If you will be coming in, you need the card with you. We do not accept American Express for any repair payments. Please call one of our Customer Care Agents with any questions before submitting this form.
Security Notice: It is never recommended that you give credit card, or personally identifying information via electronic communications. Please FAX this form for security reasons.
Direction to Pay
We use this form to authorize us to receive payments direct from your insurance company when required. This applies to any payments not already sent to you, and helps to take you out of the middle.
This form is for all repairs where an insurance company, or third-party provides payment, unless superseded by a specialized form. Please confirm with your Customer Care Agent if you are unsure.
You may email your documents, or if you prefer, use the form below.
Please do not use this form for any of the following documents:
- Credit or Debit Card or check images,
- Driver’s License or other identifying documents,
- Any documents with personal identity information, or payment information.
You may fax sensitive documents to 413-549-4111.