Service Request Form

PHONE: 512-447-5581

FAX: 512-447-4601

Please fill in the following information in the electronically active fields to allow us authorization to commence diagnostic and/or repair work on your vehicle. If you prefer you can click here to download and print the form, fill it out and email or fax it back to us at 512-447-4601.

Initial Diagnostic Fee $135.00

You are a:*
- New Customer
- Repeat Customer
Name*
First Last
Contact Phone #*
Email*
Address
Street Address City State ZIP Code
Vehicle Information
Year*
Make*
Model*
Licence Plate Number*
Color of Vehicle*
VIN
(if available)
Description of Issue or Requested Work:*
Authorizations
Please check box to add the towing charges to my invoice / bill (if applicable):*
- Yes
- N/A
Authorization Agreement*
I authorize B&B Muffler and Automotive to perform an initial diagnostic to assess what is necessary to repair my vehicle. Customer authorizes the diagnosis and testing disassembly of the vehicle or subsystem(s) to identify, assess and estimate repair costs, and/or perform the necessary repair work herein set forth along with the necessary material(s) outlined before me by B&B Muffler and Automotive Service Center. I am the person, or agent acting on behalf of the person, who is obligated to pay for the repair of the motor vehicle mentioned and hereby grant approval to proceed.
Please enter your name or the name of authorized agent below.

First Last
Sign to agree to authorization above.*
Use your mouse, or your finger or stylus on a touch screen, to sign in the area below to agree to this authorization.
Total $ Amount Authorized:*
Date*
MM slash DD slash YYYY
R.O. / P.O.#
Please be advised that unforeseen conditions may be present that may affect estimated repair costs. Every attempt is made to accurately estimate what it takes to correct the customer complaint, however, revised estimates may be necessary upon disassembly.
** NOTICE PURSUANT TO TEXAS PROPERTY CODE SECTION 70.001 **
I am the person or an agent acting on behalf of the person who is obligated to pay for the authorized repairs or services rendered to the motor vehicle listed on this Repair Order contract. I have authorized the diagnostic and/or repair work herein. I understand that this vehicle is subject to repossession in accordance with Section 9.609 Texas Business and Commerce Code if a written order for payment for repairs or services rendered has been stopped, dishonored because of insufficient funds, no funds or because the drawer or maker of the order has no account or the account on which it is drawn has been closed.
Use your mouse, or your finger or stylus on a touch screen, to sign your name in the area below to agree to the above notice.
Date*
MM slash DD slash YYYY
For Security:

Service Request Form

Vehicle Information

Authorizations

For Customers

Shop Hours

REPAIR DEPT:

EXHAUST DEPT:

VISIT OUR SHOP: