Towing/Property/Storage Acknowledgement

Towing/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
Vehicle Model
Vehicle Color
Vehicle Storage and Charges Acknowledgment

By leaving vehicle on the property, I acknowledge and agree to the following:
- Reason for Storage: My vehicle has been left on the premises of Smitty’s Maintenance Repair & Collision, Inc. (“Smitty’s”) due to an accident, breakdown, repair, or other circumstance.
- Storage Charges and Repair Authorization: Daily storage charges may apply while my vehicle remains on Smitty’s Maintenance Repair & Collision, Inc.’s premises. If I authorize repairs, daily storage charges will not apply. If storage charges apply, they will continue until the vehicle is removed from the premises or alternative arrangements are agreed to in writing by Smitty’s.
- Financial Responsibility: I understand that I am financially responsible for all applicable fees and storage charges, repair costs, and other expenses incurred in connection with my vehicle, regardless of whether my insurance company or another party has agreed to pay them. I remain responsible for any amounts not paid by the insurance company or other party.
- Personal Belongings: Smitty’s is not responsible for missing, lost, or stolen personal belongings, valuables, or other items left inside the vehicle while it is on the premises. I am responsible for removing all personal belongings from the vehicle.
- Vehicle Security and Liability: While my vehicle remains on the premises, Smitty’s is not responsible for loss of or damage to the vehicle or its contents resulting from theft, vandalism, weather, acts of third parties, or other causes, except to the extent liability cannot be excluded under applicable law.
Towing Acknowledgment

I acknowledge and authorize that my vehicle will be towed to Smitty’s Maintenance Repair & Collision, Inc. for inspection, evaluation, and/or repairs. I understand that the vehicle will be transported to the facility by a towing service and authorize the delivery and receipt of my vehicle at the business location.
Does the Vehicle need to be towed? If yes, the next 5 questions must be completed.
Vehicle location for tow
Will the Vehicle Owner/Representative be present?
Where will the Keys be located?
What is the issue with the vehicle?
Date of Tow Request

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
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: