AUTHORIZATION FORM Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Name *FirstLastAddress *City, State, Zip * updating repair Zip Work Phone *Home Phone *Cell Phone/Other *Vehicle *Email *(We will be updating you throughout the repair process, please choose how you would like to be contacted) check all that apply Phone CallTextEmailNone just call me when it’s donePAYMENT OPTIONS CUSTOMER PAYINSURANCE PAYInsurance Company NameClaim#Have you received an insurance check:YesNoREPAIR AUTHORIZATION *I AGREEAll deductibles, customer paid repairs, betterment, and insurance repairs must be PAID IN FULL at the time the car is released to the owner. I hereby authorize Chayo’s Paint & Body (CPB) to make specific repairs unless it is an economic total loss, together with the furnishing by CPB of the necessary parts and other material for such repair, I agree: that CPB is not responsible for the delay caused by the unavailability or delay of availability of parts and material for any reason; that CPB neither assumes nor authorizes any other person to assume for CPB any liability in the connection with such repair; that CPB shall not be responsible for the loss or damage to the above vehicle, or articles left there in case of fire, theft, or any other reason beyond the control of CPB; that an express mechanics lien is hereby acknowledged on the above vehicle to secure the amount of the repairs thereto; the employees of CPB may operate on the above vehicle on the streets, highways, or elsewhere for the purposes of testing and/or inspecting such vehicle. I agree Chayo’s Paint & Body may send repair updates and occasional promotions to the mobile number I provide using an automated system. I can reply STOP to opt out anytime and consent is not a condition of service or purchase. Upon signing you authorize Chayo’s Paint & Body POWER OF ATTORNEY to endorse to any payment to this repair. NOTICE PURSUANT TO 70.001 TEXAS PROPERTY CODE. I AM THE PERSON OR AN AGENT ACTING ON BEHALF OF THE PERSON WHO IS OBILGATED TO PAY FOR THE REPAIR OF THE MOTORS VEHICLE SUBJECT TO THE REPAIR CONTRACT. I UNDERSTAND THAT THIS VEHICLE IS SUBJECT TO REPOSSESSION IN ACCORDANCE WITH 9.503 OF THE TEXAS BUSINESS AND COMMERCE CODE, IF A WRITTEN ORDER PAYMENT FOR REPAIR ON THE VEHICLE IS STOPPED OR DISHONERED BECAUSE OF INSSUFICIENT FUNDS, NO FUNDS BECAUSE OF THE DRAWER OF MAKER OF THE ORDER HAS NO ACCOUNT OR THE ACCOUNT ON WHICH IT IS DRAWN HAS BEEN CLOSED.Submit