If your customer has a LifeSafer Ignition Interlock device installed in their vehicle, please fill out the form below, and a mechanic’s code will be provided to you so you can safely complete the needed repairs. Please be sure to complete the entire form.

This form is to be completed only by the certified mechanic performing the work. Once submitted, LifeSafer will review all information and if there are questions, you may be asked to provide additional information.

Instructions

Complete this form in 5 steps and upload the form and documents. You can also fax or email the completed form to LifeSafer®.

You can also return completed forms to:
FAX: (844) 663-9931
Email: [email protected]

MECHANICAL BYPASS authorization codes are required by a monitoring authority when the interlock-equipped vehicle is serviced.
The client must use a licensed service center.

1. To authorize bypass, complete this form order.

2. Attach a copy of the work order on company letterhead, invoices, and/or receipts associated with this vehicle service/repair.

3. Submit this form via fax, email, or uploading it to our website. Once received, LifeSafer will review and contact the mechanic directly with further bypass instructions.

**Please be advised this may take up to 2 business days.


TO BE COMPLETED BY THE MECHANIC PERFORMING THE WORK

Step 1 of 4

  • LifeSafer Client Information

    All LifeSafer client information must be for the individual to who the ignition interlock is assigned too.