Vehicle Service Authorization

First Name

Last Name

Email

Phone

Payment Payment Insurance Company Self Pay

Year

Make

Model

Please check each box to authorize service Please check each box to authorize service I hereby authorize Preston Colllision to DISSASSEMBLE AND COMPLETE the necessary repairs to my vehicle. A service advisor will provide me an oral/written evaluation of the damage. I authorize Preston Collision to Operate my vehicle for the purpose of testin0g inspecting or sublet repairs, pickup or delivery. I authorize Preston Collision to negotiate with insurance companies on my behalf DIRECTION TO PAY: I authorize all insurance payments be made to Preston Collision. I understand that I am responsible for all deductible payments and any pre-issued payments authorize all supplement amounts be paid to Preston Collision. An express mechanics lien is hereby acknowledged on the above vehicle to secure the amount of the repairs. I will not hold Preston Collision liable for loss or damage to the vehicle in case of fire, theft or accident. PRESTON COLLISION IS NOT RESPONSIBLE FOR ANY PERSONAL ARTICLES LEFT IN THE VEHICLE. I ACKNOWLEDGE I HAVE REMOVED OR WILL REMOVE ALL PERSONAL ARTICLES FROM MY VEHICLE. In order to diagnose necessary repairs, I authorize Preston Collision to access the vehicle's electronics data. Due to current issues with parts availability, materials, and labor shortages PRESTON COLLISION WILL NOT BE RESPONSIBLE FOR RENTAL CHARGES BEYOND INSURANCE COMPANY APPROVED PERIOD OR POLICY LIMITS. This authorization is subject to your consent to electronic transactions and disclosures. You agree that your electronic signature has the same force and effect and is the legal equivalent of your manual signature. Checking this box, and the above boxes, indicates that YOU HAVE READ, UNDERSTAND AND AGREE to the above terms.