After Hours Drop Off

Contact Info

Name

Phone

Address

Apt. / Suite

City

State

Zip Code

Vehicle Info

Make

Year

Wheel Lock

Yes

Model

Mileage

Color

License Plate #

When would you like to pick up your vehicle? Please include day and time.

Service Information

Do you have an appointment?

Yes

Other requested services or descriptions of problem(s)

Customer Preference (Please Check One)

Customer preference

Call with an estimate to receive authorization before proceeding with repair

Authorize repair with no limits and waive right to receive an estimate

Authorize repair up to this limit (enter in next step):

Authorized limit

Disclaimer

I hereby authorize the repair work herein set forth to be done along with the necessary material and agree that Harris Auto & Tire is not responsible for loss or damage to vehicle or articles left in vehicle in case of fire, theft, or any other cause beyond our control or for any delays caused by unavailability of parts or delay in parts shipments by the supplier or transporter. I hereby grant Harris Auto & Tire and/or employees 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 to secure the amount of repair thereto. Harris Auto & Tire is not responsible for any personal property left in cars such as guns, cameras, phones, laptops, tablets, clothing, money, etc.

Type your name here (acts as your signature)