BEARD AUTO REPAIR INC.
AFTER HOURS DROP OFF FORM
Phone# (630) 964-5544
Fax# (630) 964-5669
beardautorepair@gmail.com

Please enter your information, print and place in an envelope with your keys.
*drop box is located at the front entrance in the right entry door.

CONTACT INFO:
NAME:

HOME# WORK# CELL#

EMAIL -

VEHICLE INFORMATION:

MODEL:

PLATE: MILEAGE:

BRIEF DESCRIPTION OF REPAIRS NEEDED:

MAINTENANCE SERVICES (Please check all that apply)

Lube, Oil & Filter Change
Tire Rotation
Check Brakes
Check Air Conditioning


 Coolant Flush
Power Steering Flush
Transmission Flush Brake Fluid Flush


Balance Tires
Tire Repair
Wiper Blades
Safety Check
Emission Failure (please include EPA failure sheet given to you)
I hereby authorize the above repair work to be done along with the necessary material, and
hereby grant you and/or your employees permision to operate the car, truck, or vehicle herein described on streets, highways, or elsewhere for the purpose of testing and/or inspection. An express mechanic's lien is hereby acknowledged on the above car, truck, or vehicle to secure the amount of repairs there to:
Authorized by: _______________________________________________________

Thank you for your business!
Gene Beard - Owner