As the person, vehicle insurer or a vendor working on behalf of the vehicle insurer seeking to redeem an impounded vehicle, I acknowledge receipt of this written notice of rights in redeeming the vehicle. I understand that I have the right to request a hearing in district/municipal court and have received a form to make such a request. I have received a copy of the towing and storage receipt, the name of the person or agency authorizing the impound, and I acknowledge that this Right of Redemption and Opportunity for a Hearing form will serve as a receipt for the vehicle.