Amendment Form



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Repair shops that use Mitchell Connect use this form for any post payment supplements.

Repair shops that do not use Mitchell Connect use this form to request amendments to the original estimate. The repair shop completes the amendment form to request additional parts and labour on a claim. A repair shop may also use the amendment form for the final repair account submission, listing all changes made to the estimate over the course of repair.

Requests on amendment forms should be supported with images.

The Estimate Amendment form is printed from the MPIPartners site.

The repair shop faxes completed amendment forms to MPI to be reviewed by an estimator, who will notify the repair shop of the outcome of their review.

Key Areas

Area

Description

Claim, vehicle, and repair facility information

The repair shop completes all fields at the top of the form. A Shop Reference Number is optional and provided to accommodate repair shops with internal reference systems.

Image file sent: Yes/No

The repair shop must indicate whether damage images have been sent to accompany the amendment form.

Request table

The repair shop enters their requests in the table in the middle of the form, with the exception of the Approved and Denied columns.

  • If the repair shop is using the form as a final repair account cover sheet, they will list all changes approved over the course of repair.

C77#, Date, Approved By, Fax/Phone/Roadcall

The estimator completes these fields while reviewing the amendment.

Totals table

The repair shop may provide subtotals for parts, labour, material, hazardous waste disposal, and tax before providing a gross total for all requests on the form. All marginal repair estimates and contract repairs require the Totals table.

  • If the repair shop is using the form as a final repair account cover sheet, they may use this table to provide totals of all changes made to the estimate over the course of repair.

For Repair Firm Use Only

The repair shop enters the amount of betterment, tax, and deductible that the customer is responsible to pay to the shop. These fields may be left blank until the final repair account.

Customer Response

The total amount the customer must pay to the repair shop, determined by adding depreciation, tax, and deductible amounts.