I, [Customer Name], hereby grant State Road Auto Body a limited power of attorney for the sole and specific purpose of endorsing and depositing any insurance draft, check, or payment issued by [Insurance Company] in connection with Claim Number [Claim Number] for the repair of the above-described vehicle.
This limited power of attorney authorizes State Road Auto Body to:
- Sign, endorse, and negotiate any insurance check or draft made payable to the Customer and/or the Repair Facility
- Deposit said checks or drafts into the Repair Facility’s business account
- Apply proceeds toward the outstanding repair balance
Scope & Limitations: This power of attorney is limited in scope — it applies only to insurance payments related to the repair of the vehicle described above. It does not grant any authority beyond the endorsement and deposit of insurance proceeds for this specific claim. This authorization shall remain in effect until all repairs are completed and the account is settled in full, at which point it will automatically expire.
This authorization is made voluntarily and may be revoked by the Customer in writing at any time, provided that the Repair Facility has been paid in full for all services rendered. Revocation does not affect any actions taken prior to receipt of the written revocation.
