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Pre Authorization

I hereby assign Pires B. Auto Body the right to collect and retain any and all amounts required to repair the above vehicle, including but not limited to, amounts due for labor rate discrepancies, parts price discrepancies and repair procedures from my insurance company or other parties Insurance company. This includes collection and deposit of checks made out directly to the above repair company, and checks made jointly to the above repair completely and the claimant or insured for this vehicle.

Message Received!

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