Advanced Automotive Care After Hours Drop-off Form
Then fill
in all blanks and be sure to describe what you are needing repaired,
then put this form
in an
envelope (available by our key drop) with your keys and deposit through
the key drop in the door.
Thank You!
PLEASE BE SURE TO LEAVE A PHONE NUMBER WHERE WE CAN CONTACT YOU TODAY
Name:
E-mail:
Address:
City:
State:
Zip:
Home Phone:
Work Phone
Cell Phone:
Lic #:
Year:
Make:
Model:
Color:
Service
Requested:
Description:
□Oil
change / Lube
□30/60/90K Service
□Timing
Belt
□Hard
start cold
□Hard
start warm
□
Alignment
□Rough
running
□Transmission Service
□Overheating
□Air
conditioning
□Brakes
□
Coolant leakage
□
Exhaust
□
Other Service or Repair (Please Explain)
I hereby authorize
the repair work hereinafter set forth to be done along with the
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 for any delays
caused by unavailability of parts or delays in part shipments by the
supplier or transporter. I hereby grant you and / or your
employee’s permission to operate the vehicle herein described on
streets, highways or elsewhere for the purpose of testing and / or
inspection. An express mechanic’s lien is hereby acknowledged on
above vehicle