Repair Authorization Form

Repair Authorization Form

Please fill out this form to authorize the necessary repairs on the item.

Customer Information

Name

    Address

      Phone number

        Item Details

        Item

          Make

            Model

              Description of Issue

                Terms and Conditions

                1. Repair Authorization: The customer authorizes [Your Company Name] to inspect the equipment. Additional costs may apply if unforeseen damages are discovered during the repair process.

                2. Payment and Liability: Full payment is required upon completion of repairs. [Your Company Name] is not liable for any damages resulting from pre-existing conditions or third-party modifications.

                • I have read, understood, and agree to the terms and conditions outlined above.

                Name:

                Date:

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