Vehicle Release

Authorization to Release Vehicle

"*" indicates required fields

VEHICLE OWNER AUTHORIZATION FOR ANOTHER PARTY TO ACCESS

Vehicle Information

Year*

Make*

Model*

VIN*

Date of Loss*

Name*

am the lawful registered owner of the aforementioned vehicle that was towed/recovered/stored by Fred Robertson Wrecker Service.

On this day,

Name*

I hereby authorize Fred Robertson Wrecker Service to release the aforementioned vehicle and all remaining contents to:

Name (Authorized Individual),
Ex: -Insurance (statefarm, allstate, geico etc..)
-Individual other than yourself (specific names)

Name*

Proof of Ownership Can Be:
1. Vehicle Insurance Card
2. Title
3. Vehicle registration paperwork (Tag Receipt)

I understand that I am responsible for all fees associated with the towing, recovery, and/or storage of the above- described vehicle and the signing of this agreement does not in any way release the vehicle owner from that responsibility, Additionally, I understand that Fred Robertson Wrecker Service is not responsible for any loss of personal property or vehicle damage that is not disclosed in writing prior to the vehicle being removed from Fred Robertson Wrecker Service's Premises. I agree to indemnify and hold harmless Fred Robertson Wrecker Service from any and all legal action pertaining to the vehicle stated herein or the contents thereof.

Photo ID*

Accepted file types: jpg, gif, png, Max. file size: 64 MB.

Proof of Ownership*

Accepted file types: jpg, gif, png, pdf, Max. file size: 64 MB.

Signature*

Date*