This one is a classic:
name-----------------------------date----/-----/----
address----------------------------------------------
---------------------------------------------------------
[_quantity__[____description_______[_price__]_amount__]
[_quantity__[____description_______[_price__]_amount__][_quantity__[____desc
ription_______[_price__]_amount__][_quantity__[____description_______[_price
__]_amount__][_quantity__[____description_______[_price__]_amount__][_quanti
ty__[____description_______[_price__]_amount__][_quantity__[____description_
______[_price__]_amount__][_quantity__[____description_______[_price__]_amou
nt__][_quantity__[____description_______[_price__]_amount__][_quantity__[___
_description_______[_price__]_amount__][_quantity__[____description_______[_
price__]_amount__][_quantity__[____description_______[_price__]_amount__]
_____________________________________Tax[_______]
____________________________________Total[_______]
Received by X___________________________________
Invoice number Thank You
automotive lockouts?
__________________________________________________________
AUTHORIZATION & HOLD HARMLESS RELEASE AGREEMENT
I do hereby authorize and hold harmless
all persons associated in any way with the
unlocking of said Vehicle and hereby
promise to release said person(s) of any
civil or criminal charges or any property
damage that may occur in consideration
of the unlocking of said vehicle.
In witness whereof, I have placed my signature
here on the ______day of____, 19__
Authorizing Party ___________________
Drivers License # ___________________
Vehicle Vin # ______________________
Authorized Party __________________________
(person to perform opening)
_____________________________________________
g'day
Emergency Service Authorization - Auto
Please print all information
Date ____________________ Invoice # ______________________
Notes
Name __________________________________________________
Address ________________________________________________
City/St/Zip ______________________________________________
DL/ID# ___________________________ Exp/DOB _____________
Make _______________ Mod ____________ Color ____________
Lic# _____________ St. _______ Vin# ______________________
Year _________ Phone # ( ) ________ -- ______________
Location of Veh. _________________________________________
Locksmith ______________________________________________
Call Rec'd _________________________________________ Registered Owner
Family Member Employee Agent
Dispatched __________________________________ Shop hours Evening
Morning W/E Holiday Late night
Time arrived __________________________ Local
______________________________________
Time departed _________________________ Out of base area
______________________________
There HAS NOT been a previous attempt to unlock this vehicle.
Sig
nature ________________________________________
There HAS BEEN a previous attempt to unlock this vehicle.
Signature
________________________________________
Authorizing Signature _______________________________________________
There will be a $25.00 charge on all returned checks. NO EXCEPTIONS!
My signature affirms that the above information is true and complete. I hereby
authorize the Locksmith to perform the work indicated and accept responsibility
for payment upon completion (Unless advanced credit approval). I agree to
indemnify and hold blameless the Locksmith and the Lock Company in the
performance of this work. I have disclosed any unusual problems that would
affect the unlocking of this vehicle. An express mechanics lien is acknowledged
on this vehicle to secure the fee for service provided thereto.
There will be a $25.00 paperwork fee & 1.5 % per month finance charge on all
overdue invoices. All invoices are due 10 days from date of work.
Service call (inc 1ST 1/2 hour labor) $67.50 Parts
$_____________________________________
Add'l repair labor $__________________________________ Total parts
$________________________________
Total $___________________________________________ Sub-total
_________________________________
PA/Phila sales tax $__________________________
Emer/svc/frm rev 04/04
Total $____________________________________
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