UCAA Form 12 - National Association of Insurance …
FAX NUMBER: _____ FROM: _____@ Dudley Street Auto Body. TEL: 781-648-0805. FAX: 781-641-2639. DIRECTION TO PAY. I authorize the insurance company to send payments for repairs directly to Dudley Street Auto Body. I also acknowledge that this form is required for the release of my vehicle if this claim has not been paid in its entirety upon ... ................
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