Vehicle Release

SMITTY'S MAINTENANCE REPAIR & COLLISION, INC.

3301 Freemansburg Avenue Easton, PA 18045 * 610-258-5297
VEHICLE RELEASE
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Vehicle Year*
Vehicle Make*
Vehicle Make*
Vehicle Identification Number*
I, First Name Last Name , am the legal and rightful owner of said vehicle presently stored on the property of Smitty's Maintenance Repair & Collision, Inc. I authorized the personnel of Smitty's to release said vehicle thus by agreeing to the terms selected below.
Please ACCEPT all that apply:
Removed license plate(s) from said vehicle.

ACCEPT
Removed personal belongings from said vehicle.

ACCEPT
Grant permission to release said vehicle to Insurance/salvage company for disposal. Once permission is accepted, if license plate or personal belongings are not removed they will remain with the vehicle when released.

ACCEPT
Grant permission for Smitty's Maintenance Repair to release said vehicle to a towing company or another person. (Please call Smitty's to give name of authorized individual/company). Once permission is accepted, if license plate or personal belongings are not removed they will remain with the vehicle when released.

ACCEPT
Removing said vehicle from Smitty's within 24 hours.

ACCEPT
Have signed title for said vehicle to Smitty's Maintenance Repair & Collision, Inc. for disposal and presented my current Driver's License.

ACCEPT
I understand while said vehicle is at Smitty's: towing, storage, and other fees are accruing and may be my responsibility. Storage fees accrue at $150/day until said vehicle has been removed.*

ACCEPT
A possessory lien is hereby acknowledged on said vehicle until towing, storage, administrative and additional fees accrued have been paid in full.

By signing this Vehicle Release, I approve the release of said vehicle in its present condition and release Smitty's Maintenance Repair & Collision, Inc. and any of its agents harmless from any claims concerning this vehicle.
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SMITTY'S MAINTENANCE REPAIR & COLLISION, INC.

VEHICLE RELEASE