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) Reset signature Signature locked. Reset to sign again EmailThis field is for validation purposes and should be left unchanged. Δ
