Name* First Last Email* Phone*Address* Street Address City ZIP Code About Your VehiclePlate Number*Mileage*Year*Color*Make/Model*ServicesService Checklist* Change Oil & Filter AC/Heating System System/Overheating Brakes/ABS Exhaust System Check Engine Light Transmission Tune-Up Balance & Rotate Cooling System State Inspection Electrical Repair Steering/Suspension Vibration/Noise No StartOther Services / Description of Problem(s)I hereby Authorize the repair work hereinafter set forth to be done along with necessary material and agree that you are not responsible for loss or damage to vehicle or articles left in vehicle. In case of fire, theft, or any other cause beyond your control or any delays caused by unavailability of parts or delay in parts shipments by the supplier or transporter. I hereby grant you and/or your employees permission to operate the vehicle herein described on streets, highway or elsewhere for the purpose of testing and/or inspection. An express mechanic lien is hereby is acknowledge on above vehicle to secure the amount of repairs thereto.
