AUTHORIZATION TO REPAIR

    (You have the right to select any repair facility to repair your vehicle)

    Preferred Location:
    BaytownNorth Channel

    I authorize Bates Custom & Collision to estimate and repair my vehicle, unless it is an economic total loss.


    BY CLICKING SEND I AM DIGITALLY SIGNING THIS FORM

      DIRECTION TO PAY

      (You will receive a separate email instructing you to complete this section when your repairs are complete)


      I have received a copy of the initial and final automated repair estimate.

      I authorize State Farm to pay Bates Custom & Collision on my behalf:

      Repair Location:
      BaytownNorth Channel



      BY CLICKING SEND I AM DIGITALLY SIGNING THIS FORM