Vehicle Release Name(Required) First Last Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Vehicle Make(Required) Vehicle Model(Required) Vehicle Year(Required) VIN(Required) Ownership(Required) I certify that I am the legal and rightful owner of said vehicle presently stored on the property of Smitty’s Maintenance Repair & Collision, Inc. I authorized the personnel of Smitty’s to release said vehicle thus by agreeing to the terms selected below.Please initial in the parenthesis all that apply:(Required) Removing said vehicle from Smitty’s within 24 hours Removed license plate(s) from said vehicle Removed personal belongings from said vehicle Have signed title for said vehicle to Smitty’s Maintenance Repair & Collision, Inc. for disposal and presented my current Driver’s License Grant Insurance company permission to pick up said vehicle I understand towing, storage, and other fees are my responsibility and that storage fees accrue at $105/day until said vehicle has been removed Permission(Required) I certify that I grant permission for Smitty’s Maintenance Repair to release said vehicle to the person listed below for removal/disposalThe Vehicle Should Be Released to:(Required) A possessory lien is hereby acknowledged on said vehicle until towing, storage, administrative and additional fees accrued have been paid in full. By signing this Vehicle Release, I approve the release of said vehicle in its present condition and release Smitty’s Maintenance Repair & Collision, Inc. and any of its agents harmless from any claims concerning this vehicle.Date(Required) MM slash DD slash YYYY Signature(Required)NameThis field is for validation purposes and should be left unchanged. Δ
