Property/Storage Acknowledgement

Property/Storage Acknowledgement
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Preferred Method of Contact
TEXTING CONSENT: Smitty's would like to send text (SMS) messages to the mobile number you have provided in our records. By signing this form, you are agreeing to receive text (SMS) messages from Smitty's relating to my vehicle repairs. Message frequency varies. Message & data rates may apply. Reply STOP to opt-out at any time.
Vehicle Year
Vehicle Make and Model
Date Left on Property

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Storage and Charges Acknowledgment

By leaving vehicle on the property, I acknowledge and agree to the following:
- Vehicle has been left on the property due to an accident, breakdown, repair, or other circumstance.
- While vehicle remains on the property, I understand that Smitty's is not responsible for theft, vandalism, weather damage, damage caused by third parties, or other loss or damage to my vehicle or its contents.
- I understand that a daily storage charge may apply while my vehicle remains on the property. If I authorize Smitty’s Maintenance Repair & Collision, Inc. to repair my vehicle, no daily storage charges will be charged. I am still responsible for any actual expenses incurred, such as towing, recovery, transportation, or other third-party charges.
- I understand that I am responsible for any applicable storage charges and other charges incurred, even if my insurance company or another party agrees to pay them.
- Storage charges continue until my vehicle is removed from the property or other arrangements are made in writing with Smitty’s.
- I am responsible for removing personal belongings and valuables from the vehicle. The property is not responsible for personal items left inside the vehicle.
Additional Fees and Charges

I understand that, in addition to daily storage charges, other fees and charges may apply while my vehicle is on the property. These may include, but are not limited to:
- Towing or towing-related charges
- Administrative or processing fees
- Vehicle cleanup or debris removal
- Other reasonable costs or expenses incurred in connection with the vehicle
I understand that I am responsible for these charges whether or not an insurance company or another party agrees to pay them.
Customer Acknowledgment

By signing below, I acknowledge that I have read and understand this notice and accept responsibility for storage charges and other applicable fees and charges associated with my vehicle while it remains on the property.
Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty: