By completing and executing this form, the undersigned, authorizes Box-n-Go, LLC to cut the padlock on the below identified unit(s):

Customer further agrees to indemnify, defend and hold Box-n-Go, LLC harmless from and against all claims,  damages, losses and liabilities, cost and expense (including attorneys fees and costs whether or not arising out of third party claims, including, without limitation, claims brought by any other Customer of Box-n-Go) which relate to property loss or damage sustained by any person or entity, whether disclosed or not, as a result or arising out of or caused by the above padlock removal.

The signature below is to certify that I personally filled out the above authorization form and understand and agree with all the terms that apply. I further  warrant and certify that the signature below is mine and matches the signature that appears on the attached driver’s license.