Laws vary by state; check your state's requirements.
| Shop | Sample Auto Repair | Address | 123 Main St, Anytown, OH 00000 |
|---|---|---|---|
| Date in | 2026-11-04 | Time in | 08:40 |
| Customer | Jane Doe | Phone | (555) 010-0199 |
| [email protected] | Vehicle | 2016 Honda Accord | |
| VIN | 1HGCM00000A000000 | Plate | SAMPLE OH |
| Mileage | 81234 | Fuel | 1/4 |
| Concern | Grinds when stopping | ||
| Work authorized now | Diagnose front brakes | ||
| Diagnostic fee | $140.00 | Applied to repair if approved | Yes |
| Diag hours | 1.0 | Do not exceed | $140.00 |
| Contact before exceeding | text | Return old parts | No |
| Storage terms | per state law | Advisor | John Smith |
| Customer signature | Date | ||
| Date | Time | Name | Method | Amount |
|---|---|---|---|---|
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