Vehicle Tow And Work Request Form printable pdf download

B&B MUFFLER & AUTOMOTIVE SERVICE CENTER

3000 South Lamar Blvd. Austin, TX 78704

Phone: (512) 447-5581 Fax: (512) 447-4601

Vehicle Tow & Work Request Form

Please fill in the following information and fax it back to us at the enclosed fax phone number.

This is necessary to acquire the proper information, allow us to have the vehicle towed to our

shop and begin the necessary initial diagnostic and/or repair work.

Please fill in the following information requested:

□

Customer:

New

Repeat

Date of Request: ___/___/20___

Name _______________________

Contact Phone # ____________________

Address _______________________________ City ___________ State _____ Zip ______

Year _______ Make ___________ Model _______________

Vehicle:

License Plate Number: ____________ Color of Vehicle ___________

VIN: __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ (if available)

Location of vehicle:

Address

___________________________________

Cross Streets ___________________________________

Authorization to Tow Vehicle:

Typical Tow Costs: In Austin - $80.00 / Outside of Austin (West Lake / Rollingwood) $100.00

Vehicles that require a tow dolly $110.00 (Hybrid vehicles)

Initial Diagnostic $110.00

I authorize B&B Muffler and Automotive to tow my vehicle to their facility and perform an initial diagnostic to assess what is

necessary to repair my vehicle. Customer authorizes the diagnosis and testing disassembly of the vehicle or subsystem(s) to

identify, assess and estimate repair costs, and/or perform the necessary repair work herein set forth along with the necessary

material(s) outlined before me by B&B Muffler and Automotive Service Center. I am the person, or agent acting on behalf of

the person, who is obligated to pay for the repair of the motor vehicle mentioned and hereby grant approval to proceed.

Name or Authorized Agent (Print): ___________________

Signature: _________________________

TOTAL AMOUNT AUTHORIZED: $ ____________

Date: ____________

R.O.:________

Please be advised that unforeseen conditions may be present that may affect estimated repair costs. Every attempt is made to

accurately estimate what it takes to correct the customer complaint, however, revised estimates may be necessary upon

Thank You!

disassembly.

Vehicle Tow And Work Request Form