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Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Phone*
Vehicle Information
Vehicle Make
Vehicle Year
Vehicle Model
Color
License Plate #
Alarm Remote Needed
- Yes
- No
Wheel Lug Key Available
- Yes
- No
Work To Be Performed
Symptoms
Warning Lamps Illuminated
- Yes
- No
Save Old Parts
- Yes
- No
Estimate Not to Exceed $ Without Further Authorization*
Work Authorization*
Work Authorization:
By typing my name below I hereby authorize Sav-Mor Automotive to perform the above repairs along with the necessary materials. Sav-Mor Automotive and it's employees may operate this vehicle for the purpose of testing, inspection or delivery at my risk. An express mechanics lien is hereby acknowledged on this vehicle to secure the amount of repairs thereto. It is also understood that Sav-Mor Automotive will not be held responsible for loss or damage to vehicles or articles left in vehicles due to fire, theft or any other causes beyond their control, or to cars left on the premises after notification of completion of work.
Signed*
First Last
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Vehicle Information