Marlboro Auto Repair, Tire & Collision
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Vehicle Release Form
Vehicle Release Form
Your Name prefix, Mr or Mrs?
Vehicle Release Form
Date *
FIRST - MIDDLE NAME - LAST NAME *
Address *
Phone Number *
Your E-mail *
I authorize the release of my vehicle to my friend/family-member/Insurance company/Bank/Other and take responsibly of the vehicle thereof *
Yes: Release to Friend
Yes: Release to Family member
Yes: Release to Insurance Company or their partners
Yes: Release to Bank
Yes: Release to OTHER
Name of Person or Company taking the vehicle *
YEAR-MAKE-MODEL OF CAR *
Note to Repair shop if any
Verification Code *
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