Jack Demmer
Collision Centers
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Please carefully complete all of the pre-application questions below:
Name
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Phone
*
Email
*
Make
*
Model
*
Year
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Location:
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Demmer Wayne
Demmer Dearborn
Appointment Date
*
Insurance Co:
*
Insurance Claim #
*
Description of Damage
*
Comments
*
Type of Repair Needed:
*
Collision Repair
Theft Repair
Glass Replacement
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