Vehicle Release Form – Call us at (630) 584-4399

Section 1 - Owner and Vehicle Information:

I, am the legal and rightful owner of the below listed motor vehicle presently stored at Certified Towing & Recovery and thus authorize
t!he personnel of said company to release said vehicle to the following person(s) and/or insurance company, and/or agent thereof.

OWNER INFORMATION:
NAME:
DRIVERS LICENSE NUMBER:
PHONE NUMBER:
ADDRESS:
CITY/STATE:
ZIP CODE:

VEHICLE INFORMATION:
Vehicle Year: Vehicle Make: Vehicle Model:
VIN:

Furthermore, I understand that in the event that the aforementioned motor vehicle is to be released to an individual person, that person will be required to present a “valid” photo identification card that must be in one of the following forms: 1) Any U.S. State issued drivers license, 2) Any U.S. State issued personal identification card, 3) U.S. Military i!dentification card or, 4) U.S. Government issued Passport, with Photo. I am also aware that in the event that the said motor vehicle is in a ‘drivable” condition, a person with a “valid” drivers license from any state within the United States, will be the only individual allowed to remove said motor vehicle off of any and all vehicle storage properties, or otherwise, owned and operated by CTR, and that said person (driver) will be required to produce proof of this drivers license upon demand by personnel at CTR.

Section 2 - Company and or person(s) authorized to inspect or remove the vehicle:

Print Name:
Claim Number:

I am a duly authorized licensed Ins. adjuster representing authorized to conduct business in the State of Illinois. The claim related to this vehicle settled or, prior to settlement, the vehicle owner expressly authorized its inspection and/or removal.

Additional Documentation

Please upload any additional documents we may need (ex: Valid ID, Registration or Insurance Card)
File 1:
File 2:
File 3:

Notice Owner Vehicle:

A copy of your drivers license, VALID insurance, motor vehicle registration card, certificate, or Title MUST accompany this form. In the event that the owner is authorizing this release from either a hospital bed, or while in any prison and/or jail, he/she must have this form signed and witnessed by a legal certified/commissioned Notary Public.

OWNER SIGNATURE:
DATE: