Baker's Collision Repair

Estimate

First Name:*	Last Name:*

Address:	City:

State: Zip:	Phone:

E-Mail:*	Vehicle Make:*

Vehicle Model:*	Vehicle Year:*

VIN Number: (17 digit number located on your vehicle registration)

Desired Date;	Desired Time:

Describe the damage to your vehicle:

* = Required

595 Fifth Avenue, Mansfield, Ohio 44905 419-524-1350 Fax: 419-524-8855