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    Customer Sign In Information

    1First Name & Address


    2Email & Phone

    3Insurance Company


    4Vehicle Make & Year

    Model of your Car:

    Color:

    Damage Report

    Problem: "What's wrong with my car?"

    Add Your Signature

    For your Insurance Company

    Authorization to Repair: I hereby authorize BLUE STAR BROTHERS Inc.to perform all needed repairs to my vehicle in accordance with the estimate of repairs, as well to you authorize us to drive your vehicle on roads and highways to diagnose, repair, service and inspect the vehicle.
    Direction of Payment: I hereby authorize BLUE STAR BROTHERS Inc.to accept on my behalf any and all payments for credit on my account for repairs on my vehicle which have been released and accepted.

    Please Sign Below

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