AUTHORIZATION TO REPAIR
& DIRECTION OF PAYMENT
Customer Information
Vehicle Information
Insurance Information
I do NOT wish to go through insurance and would like to pay for the repairs myself.
Legal Information
The above individual authorizes Wee Heart Autobody, LLC. (WHAB) to repair the aforementioned vehicle. WHAB is authorized to act as the above individual's agent for the purpose of negotiating the costs of repairs, including the damage discovered after the initial appraisal, with the insurer. WHAB can allocate any and all payment to facilitate the successful and proper repair of the vehicle listed above.
The above individual authorizes WHAB to operate their vehicle for the purposes of testing and diagnostics, delivery of the vehicle to the customer, and general purposes on the property of WHAB.
WHAB will not be liable for loss or damage to the vehicle, or items lost/stolen beyond circumstances that are generally reasonable or beyond our control.
The above individual recognizes that WHAB cannot reasonably be expected to release a vehicle with an outstanding balance unless the insurer has issued a written or electronic promissory document agreeing to pay the remainder of said balance. The above individual authorizes WHAB to endorse checks on their behalf for the purpose of compensation to repair the vehicle listed here-in (Limited POA).
The above individual authorizes the above listed insurance company to pay Wee Heart Autobody, LLC. directly when permissible.
Date Signed:
03/14/2025
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