Authorization and POA
**ALL CHARGES MUST BE PAID IN FULL BEFORE THE VEHICLE IS RELEASED**
ACCEPTABLE FORMS OF PAYMENT:
Properly endorsed insurance drafts, Money Order, Cash, Personal ChecksCashiers Check, MasterCard, VISA, Discover, American Express
I hereby authorize Lance’s Collision, Inc. to complete the repairs listed on the respective Work Order.
I understand the payment in full will be due upon release of the vehicle, including any supplement charges. I hereby grant you and/or your employees permission to operate my vehicle on streets, highways, or elsewhere for the purposes of testing, inspection or sublet repairs, and delivery or pick up. An Express Mechanics Lien is hereby acknowledged on above vehicle to secure the amount of repairs thereto. I will not hold Lance’s Collision, Inc. responsible for loss or damage to the vehicle or articles left in the vehicle in case of fire, theft, accident, or any other cause beyond their control. I authorize any and all supplements to be paid directly to Lance’s Collision, Inc.
For consideration of repairs made to this vehicle I hereby grant my Power of Attorney to sign or endorse any checks and/or drafts made payable to me, and release thereto, as settlement for my claim or damage to my vehicle.
By electronically signing this document, I agree to BOTH “Authorization for Repair” and “Power of Attorney” and that I have REMOVED ALL UNATTACHED PERSONAL AND VALUABLE ARTICLES from said vehicle.
Leave this empty:
If you have questions about the contents of this document, you can email the document owner.
Document Name: Authorization and POA
Agree & Sign