Insurance Forms

Please download and complete the following forms.

Repair Authorization 

Direction To Pay

Once completed please attach and submit them below.

or
Use Adobe Fill & Sign

Click “Open In Acrobat.” Click the “Fill & Sign” i-con. Fill in the form. Where the form
asks for a signature, go to form header and click “Sign.” Place your signature
at the bottom of the form. Click “Next.” Then click “Save.”
In the next dialog box, click “Send a copy” fill in
csr@northstatecustom.com
then click “send.”

  • Drop files here or
    Max. file size: 100 MB.