DIRECTION TO PAY
Cousin’s Collision Center
45 Foundry Street, Woonsocket, RI 02895-5120
Authorization to Repair
I hereby authorize Cousin’s Collision Center to perform repairs on my vehicle as described below, as per insurance company and/or customer’s request to before accident condition.
Direction of Pay
I, [CUSTOMER NAME], give [CUSTOMER’s INSURANCE COMPANY] permission to send all checks relative to the below referenced claim to Cousin’s Collision Center at 45 Foundry Street, Woonsocket, RI 02895-5120, which has preformed all repairs to my vehicle to my complete satisfaction.