Vehicle Drop-Off Repair Request
Customer Information:
Cu
s
t
o
m
e
r
N
am
e
A
dd
re
ss
Ci
t
y
ZI
P
H
o
m
e
P
hon
e
B
u
s
i
n
e
ss
P
hon
e
E
m
ai
l
A
dd
re
ss
Vehicle Information:
Y
e
ar
M
ak
e
M
od
e
l
Co
l
or
L
i
c
e
n
s
e
P
l
ate
#
Check Engine
L
i
g
h
t
On
Engine Running Poorly
(Please leave comments in the space below)
Tire
R
o
t
a
t
i
on
&
I
n
s
p
e
c
t
i
on
V
i
b
rat
i
on
or
Noise
(Please
l
e
a
v
e
comments in the space below)
Pre-Trip
I
n
s
p
e
c
t
i
on
R
e
p
l
ac
e
W
i
p
e
r
B
l
ad
e
s
Brake
I
n
s
p
e
c
t
i
on
Poor
Fuel M
il
e
ag
e
Check Engine
L
i
g
h
t
On Maintenance Due (via
Service Reminder
you have received)
Other Services Needed / Description of Problem:
Customer Signature Date
/
/
Please fill in the above information as complete and accurate as possible and leave in our drop
box with a spare copy of your vehicle key. We will promptly contact you during our regular
business hours, the following day of your vehicle arriving at our service center.
Thank you, we appreciate your continued business.
