Legal Vehicle Removal Form

LEGAL VEHICLE REMOVAL FORM

This Legal Vehicle Removal Form is entered into by and between Owner Name: and Towing Company / Agent Name: (each a "Party" and together the "Parties").

RECITALS

WHEREAS, Owner is the registered owner or authorized agent of the motor vehicle described below and seeks removal of the vehicle from the Premises or public space identified herein; and

WHEREAS, Towing Company / Agent is licensed and authorized under applicable law to tow, remove and place into storage motor vehicles and agrees to remove and store the Vehicle subject to the terms and conditions set forth in this Form; and

WHEREAS, Owner and Towing Company / Agent wish to set forth their respective authorizations, representations, indemnities, and payment obligations in writing.

NOW, THEREFORE, in consideration of the mutual covenants contained herein and other good and valuable consideration, the Parties agree as follows:

1. VEHICLE IDENTIFICATION

Vehicle Year:    Make:    Model:

Color:    VIN:

License Plate:

2. AUTHORIZATION TO REMOVE & STORE

Owner hereby irrevocably authorizes and instructs Towing Company / Agent to remove the Vehicle from the location described as Premises / Location: on Removal Date: at approximate Time: .

Towing Company / Agent shall remove the Vehicle in a commercially reasonable manner, secure the Vehicle in a storage facility, and provide Owner with documentation of removal and storage as required by applicable law. Towing Company / Agent is authorized to take custody of the Vehicle, effectuate physical removal, and transfer to storage.

3. OWNERSHIP, LIENS, AND REPRESENTATIONS

Owner represents and warrants that Owner is the legal and beneficial owner of the Vehicle or an authorized agent of the legal owner, and that there are no undisclosed liens, security interests, encumbrances or claims affecting the Vehicle except as disclosed in Lien Description below:

If any lien, security interest, or third-party claim exists, Owner agrees to promptly notify Towing Company / Agent in writing and to indemnify Towing Company / Agent for any loss arising from removing or storing the Vehicle.

4. FEES, PAYMENT, AND RELEASE

Owner shall pay all tow, removal, storage, administrative and other lawful charges imposed by Towing Company / Agent. Estimated Tow Fee: . Daily Storage Rate: .

Vehicle will be released to Owner or Owner's authorized representative upon presentation of satisfactory identification and payment in full of all fees and charges. If Owner fails to retrieve the Vehicle within the time permitted by law, Towing Company / Agent may apply all remedies available under law, including sale to satisfy lawful charges.

5. INVENTORY, CONDITION, AND DAMAGE

Prior to removal, Towing Company / Agent will perform a visual inventory and record existing damage. Owner acknowledges that additional damage discovered after removal will be documented with date and time in the Towing Company's records.

Towing Company / Agent will not be responsible for loss of personal property left in the Vehicle unless such property was listed in the inventory above and signed by both Parties.

6. INDEMNITY, RELEASE AND LIMITATION OF LIABILITY

Owner releases and holds harmless Towing Company / Agent, its officers, employees, agents and contractors from and against all claims, liabilities, losses, costs and expenses (including reasonable attorneys' fees) arising out of or related to the removal, towing, storage or sale of the Vehicle, except for claims arising from Towing Company / Agent's gross negligence or willful misconduct.

Owner shall indemnify and defend Towing Company / Agent against any third-party claims that challenge Owner's authority to permit removal or that assert superior ownership or lien rights not disclosed in this Form.

7. ACCESS, ENTRY AND PROPERTY RIGHTS

Owner grants permission to Towing Company / Agent and its representatives to enter the Premises for the limited purpose of removing and retrieving the Vehicle. Owner represents that it has authority to permit such entry and will hold Towing Company / Agent harmless for any damage to landscaping or structures reasonably necessary to effect removal, absent gross negligence.

8. NOTICES

All notices required or permitted under this Form shall be in writing and delivered to the addresses set forth below. Notice to Owner:

Notice to Towing Company / Agent:

9. GOVERNING LAW; ENTIRE AGREEMENT; SEVERABILITY

This Form shall be governed by and construed in accordance with the laws of the State of without regard to its conflict of laws principles.

This Form constitutes the entire agreement between the Parties with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements, representations and understandings of the Parties, whether oral or written.

If any provision of this Form is held to be invalid or unenforceable, such provision shall be reformed only to the extent necessary to make it enforceable, and the remaining provisions shall remain in full force and effect.

10. AMENDMENTS; WAIVER; COUNTERPARTS

Any amendment or modification of this Form must be in writing and signed by both Parties. No failure or delay by either Party in exercising any right under this Form shall operate as a waiver.

This Form may be executed in counterparts, each of which shall be deemed an original, and all of which together shall constitute one instrument. Signatures transmitted by electronic means shall be valid and binding.

11. MISCELLANEOUS ADMINISTRATIVE INFORMATION

Towing Agent Name (if different from company):

Agent License or Permit Number:    Storage Facility Address:

Owner Contact Phone:    Owner Email:

CERTIFICATION

By signing below, Owner certifies under penalty of perjury that the information provided in this Form is true and accurate to the best of Owner's knowledge, that Owner has authority to authorize the removal of the Vehicle, and that Owner understands and accepts the terms set forth herein.

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