Authorization to Impound / Tow and Vehicle Inventory
License number
State
VIN (Vehicle Identification Number)
Year
Make
Model
Vehicle being Impounded from:
Date
Month Day Year
Date
Time
A person or agency authorizing this impound, if the impound is found in violation of chapter 46.55 RCW, may be held liable for the costs incurred by the vehicle owner.
Name
Mailing address
Title
Drivers License Number
Signature
Clear
Date of impound
Month Day Year
Date
Time of impound
Individual/agency authorizing this impound:
Private property owner Private property custodian Law enforcement Other public official
This vehicle is of scrap value and I agree to pay the above named towing firm
Check Damaged Sections
1. Fenders 2. Hood/Grill 3. Windshield/Glass 4. Lights/Lenses 5. Top 6. Sides 7. Trunk 8. Bumpers 9. Doors 10. Tires/Rims 11.
Additional Items
Should be Empty: