Authorization Form

* Indicates a required field

Vehicle Information

Is damage covered by insurance?
Has Insurance issued a check to you for Pre-payment?
Do you have a deductible?
**By submitting this form, I understand that Greensboro Collision Center will not be responsible for ANY rental expenses due to the national labor and parts shortage. **

Damaged Areas On Your Vehcile

Interiror Condition & Equipment
Miscellaneous Equipment
Paint Condition
**We Cannot Accept 3rd Party Checks**
**ALL VEHICLES MUST BE PAID IN FULL BY CASH, CREDIT CARD, OR CASHIERS
CHECK BEFORE THE VEHICLE WILL BE RELEASED**
**ALL DEDUCTIBLES MUST BE PAID AT THE TIME OF RELEASE OF THE VEHICLE**
**ALL ESTIMATE AND SUPPLEMENTAL CHECKS NEED TO BE MADE OUT SOLELY TO GREENSBORO COLLISION CENTER**

PLEASE READ

I hereby authorize the above repair work to be done along with the necessary materials. 

I agree that Greensboro Collision Center is not responsible for the loss or damage to vehicle or articles left in the vehicle in case of fire, theft, or any other cause beyond their control. Rental vehicles will not be provided at Greensboro Collision Center's expense due to delay caused by parts availability, delays in the supplemental damage process or insurance re-inspection process. Our target completion dates are an estimate only and are not guaranteed, we will make every effort to deliver your vehicle back to you as quickly as possible. 

I hereby grant you and your staff permission to operate the above vehicle on streets, highways or elsewhere for the purpose of testing and/or inspection. An express mechanic's lien is hereby acknowledged on the above vehicle to secure the amount of repairs thereto I further agree to pay reasonable attorney fees and court cost in the event legal action is necessary to enforce such contract. I acknowledge that the total estimate of repairs includes all parts, labor handling, and diagnosis. I agree that if closer inspection finds that additional repairs are necessary, I will be contacted for authorization if the amount I pay will be increased. Parts prices subject to invoice. All estimate and supplemental checks need to be made out solely to Greensboro Collision Center. 

As to payment for supplemental damages approved by insurance company, by my signature, I authorize, empower, and direct the said insurance company to issue the supplemental payment naming Greensboro Collision Center of 719 Camann St. Greensboro, NC 27407, as sole payee.