Request a collision repair inspection

Who is requesting the inspection?

First Name

Last Name

Mailing Address

City

State

Zip Code

Phone Number

Alternate Phone Number

Email Address

Provide your email to receive a confirmation of your request.

How did you hear about the Auto Body Inspection Program?

Who performed the repairs?

Business/Licensee Name

License Number (if known)

Address

City

State

Zip Code

Phone Number

Tell us about your vehicle

Vehicle Year

Vehicle Make

Vehicle Model

Vehicle License Number

Does the vehicle have a salvage title?

Yes

No

Tell us about the repairs

Has anyone inspected or repaired the vehicle since the completion of the collision repair in question?

Yes

No

Was an insurance company involved in the repair?

Yes

No

Date of Service/Repair

Describe the reason for your request:

Notice of collection of personal information

BAR collects personal information only as allowed by law. For detailed information, please see the Notice on Collection of Personal Information.