Repair Authorization

Vehicle and Insurance Information

Pre-Scan and Post-Scan Authorization

This grants Rosslyn Auto Body Co. permission to perform a pre and post-repair diagnostic scan on your vehicle as part of the repair process. If you choose to decline this procedure, you acknowledge the repair shop will not be held liable for problems with the vehicle that cannot be detected without proper diagnostic scans.


I hereby authorize Rosslyn Auto Body to repair my vehicle. I agree that Rosslyn Auto Body is not responsible for loss or damage to vehicle or articles left in car in case of fire, theft or any cause beyond our control or for delays caused by unavailability of parts. I hereby grant permission to Rosslyn Auto Body employees to operate this vehicle for testing, transporting for related work or inspection purposes. I further agree to pay reasonable attorney fees and court costs in the event legal action is necessary to enforce this contract.

I acknowledge that estimate of repairs includes all parts, labors, materials, handling, and diagnosis and agree that if closer analysis finds hidden or additional damages, I agree to approve such supplemental repairs that will be paid for by the insurance company. We accept all forms of payments: Visa, Master Card, Discover, Debit Card, Cash, and Checks. If you received an insurance check you can endorse to the shop.

Power of Attorney: For consideration of repairs made to this vehicle, I hereby grant power of attorney to sign or endorse any checks and/or drafts made payable to me and any release thereto as settlement for my claim for damage to this vehicle.