Work Orders | Circle D Transmission

Name

Address

Phone

Vehicle

Last 4 of the VIN

Customer Signature

I HEREBY AUTHORIZE REPAIR WORK TO BE DONE ALONG WITH THE NECESSARY MATERIALS ON THE ABOVE REFERENCED VEHICLE. I UNDERSTAND THAT CIRCLE D MAY REQUEST TELEPHONE AUTHORIZATION FOR ANY REQUIRED SERVICE. YOU AND YOUR EMPLOYEES MAY OPERATE ABOVE VEHICLE FOR PURPOSES OF TESTING, INSPECTION OR DELIVERY AT MY RISK. AN EXPRESS MECHANIC'S LIEN IS ACKNOWLEDGED ON ABOVE VEHICLE TO SECURE THE AMOUNT OF REPAIRS THERETO. IT IS UNDERSTOOD THAT THIS COMPANY ASSUMES NO RESPONSIBILITY FOR LOSS OR DAMAGE BY THEFT OR FIRE TO VEHICLES PLACED WITH THEM FOR STORAGE, SALE, REPAIR OR WHILE ROAD TESTING.

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Person Responsible or Agent

NOTICE PURSUANT TO SECTION 70.001 TEXAS PROPERTY CODE
I AM THE PERSON, OR AGENT ACTING ON BEHALF OF THE PERSON, WHO IS OBLIGATED TO PAY FOR THE REPAIR OF THE MOTOR VEHICLE SUBJECT TO THE REPAIR ORDER TO WHICH THIS IS ATTACHED. I UNDERSTAND THAT THIS VEHICLE IS SUBJECT TO REPOSSESSION IN ACCORDANCE WITH SECTION 9.609, TEXAS BUSINESS &COMMERCE CODE, IF A WRITTEN ORDER FOR PAYMENT FOR REPAIRS OF THE VEHICLE IS STOPPED, DISHONORED BECAUSE OF INSUFFICIENT FUNDS, NO FUNDS, OR BECAUSE OF THE DRAWER OR MAKER OF THE ORDER HAS NO ACCOUNT OR THE ACCOUNT ON WHICH IT IS DRAWN HAS BEEN CLOSED.

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