Wreck Center Authorization Form

This is a legal binding document allowing The Wreck Center to work on your vehicle. All terms are listed below. Please fill out the form after reading through the content to approve the appointment so work can begin.

419.874.4331 – 419.872.4405 FAX


I hereby authorize The Wreck Center to make the specific repairs. I understand that full payment will be due upon release of the vehicle, including additional supplemental damage charges. I hereby grant The Wreck Center employees permission to operate the vehicle on streets, highways, or elsewhere for the purpose of testing and/or inspection. An express mechanics lien is hereby acknowledged on the vehicle to secure the amount of repairs thereto.

The Wreck Center will dispose of old parts removed from the vehicle unless otherwise instructed.

The Wreck Center will not be held responsible for loss or damage to vehicle or articles left in the vehicle in the case of fire, theft, accident, or any other cause not due to the negligence of The Wreck Center or its employees.


I do hereby appoint The Wreck Center to act as Power of Attorney in fact to accept on my behalf and and all checks, drafts, or bills of exchange, and to endorse all such checks, drafts, bills of exchange for deposit to The Wreck Center ‘account for credit on my account for repairs to my vehicle. I authorize any and all supplemental charges to be made payable to The Wreck Center.


*All repairs must be paid in full prior to vehicle release (Unless prior arrangements have been made).

*We do not accept personal checks over $500.00 without prior approval.

*On amounts over $500.00, we accept: cash, major credit cards, money orders, or cashier’s checks.

*All deductibles are payable to The Wreck Center.

*Multiple party checks must be endorsed prior to vehicle release.

*I have read and understand The Wreck Center’s Vehicle Release Policy.

*I understand that estimated delivery date is not guaranteed and is subject to change.

*I personally assume all risks of loss for property left in vehicle. I understand that if I cancel the repairs after parts have been ordered, I will be responsible for any restocking fees, if applicable.

Customer Name -

Customer Address -

Customer Address 2 -   

Customer City -   

Customer State - 

Customer Zip -

Customer Phone Number -   

Vehicle Make/Model - 

I Agree to the Terms and Conditions 


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Signature Certificate
Document name: Wreck Center Authorization Form
lock iconUnique Document ID: f02967d98859c3e10d6b00419bdf62a903207e37
Timestamp Audit
December 12, 2018 12:02 pm EDTWreck Center Authorization Form Uploaded by Al McGaharan - amcgaharan@pbautomall.com IP