If you would like to complete registration by mail: Please download pdf-file:
Customer Information Form

Otherwise, please continue for online registration.
* Required fields must be filled in, in order for your request to be considered.

Full Name *
Email Address *
Your Phone *
Address *
City *
State *	Zip Code *
Vehicle Model *
Year *
Your Message *

How Did You Select Our Company	Source of Repair Payment	How Did You Select Our Company
Building Sign  Customer Referral  Drive By  Insurance Agentcompany  Newspaper Ad  Printed Brochures  Repeat Customer  Radio Ad  TV Ad  Yellow Pages  Dealer Referral Other	Your Insurance Company  Their Insurance Company  Yourself Has an insurance company provided an estimate on your vehicle?  Yes    No Name of insurance company paying for this repair: Date of Accident:  Policy #:  Claim # : Deductible Amount $	Is this your:  First Estimate  Second Estimate  Third Estimate Will you have your vehicle repaired at our shop?  Yes    No    Undecided Will you need a rental car?  Yes    No Is your vehicle leased?  Yes    No

Auto Craft Body & Paint added values:
Lifetime warranty on paint and workmanship. Guaranteed paint match. We will insist on original equipment replacement parts from the insurer. We will use all factory recommended corrosion protection procedures. Your vehicle will be returned to you cleaned & polished. Tire pressures – fluid levels and all exterior lights will be checked at no charge.
Thank You for considering Auto Craft Body & Paint to repair your vehicle!