Ameriprise Auto & Home Insurance

Property Casualty Companies

3500 Packerland DR.

De Pere WI 54115-9070

 

Amex Assurance Company

IDS Property Casualty

Insurance Company

Direction of Pay

I, ________________________________________________, authorize Ameriprise Auto & Home

Insurance to process direct payment to CAR Collision Center for any repairs to my,

__________________________________________________________________________________

vehicle identification number _____________________________________________________.

This is in reference to claim number _________________________________.

 

 

_________________________________________                 ___________________________

Insured/Claimant Signature                                                       Date