By completing this form I hereby authorize the repair of the below referenced vehicle. DIGITAL CUSTOM AUTO BODY will not be held responsible for loss or damages to vehicles or articles left in vehicles in case of fire, theft or any other cause beyond their control. I understand that DIGITAL CUSTOM AUTO BODY cannot guarantee an exact delivery date, these dates are estimated only. DIGITAL CUSTOM AUTO BODY is not responsible for delays caused by the unavailability of parts or delays due to hidden damages. I also hereby grant permission to DIGITAL CUSTOM AUTO BODY to operate the above vehicle for testing and/or inspecting. An express mechanics lien is hereby acknowledged on the vehicle to secure the amount of repairs thereto. All auto body refinishing and paint has a lifetime warranty with customers original receipt for as long as the customer owns the vehicle. All wheel repairs have a 12-month warranty. All interior repairs have six-month warranty. I understand that windshields may crack during a windshield repair process. I acknowledge that DIGITAL CUSTOM AUTO BODY is not responsible for any further damage that may occur during the windshield repair process.

The total amount of the repair charges must be paid before the below referenced vehicle can be released. Any insurance deductible amount must be paid in full before the this vehicle can be released.

Additionally I hereby assign DIGITAL CUSTOM AUTO BODY the right to collect and retain all amounts required to repair the below referenced vehicle, including but not limited to amounts due for labor rate discrepancies, parts price discrepancies and repair procedures from my insurance company. This includes collection and deposit of checks made out directly to DIGITAL CUSTOM AUTO BODY and checks made jointly to DIGITAL CUSTOM AUTO BODY and the claimant or insured for this vehicle. DIGITAL CUSTOM AUTO BODY is authorized to sign or endorse in my name and on my behalf, and negotiate all checks, warrants, drafts, bills of exchange, promissory notes, letters of credit, notes or other negotiable instruments, payable to me or my order, or which may require my endorsement, related to any claims or settlement involving damages and/or repairs to the above identified vehicle, and DIGITAL CUSTOM AUTO BODY may deposit the proceeds into DIGITAL CUSTOM AUTO BODY’s account with any banks, trust companies, savings banks, savings and loan associations or other financial institution(s), wherever located, that DIGITAL CUSTOM AUTO BODY deems proper. Consideration for the authorization, release, and relinquishment of funds includes, but is not limited to, the repairs to the identified vehicle.