VEHICLE AUTHORIZATION

I certify that I am the legal owner of the below listed motor vehicle presently stored by Contrell Auto Salvage INC, and thus authorize the personnel of Contrell Auto Salvage INC. to release said vehicle to the following person and or insurance company or their agents. *

YOUR NAME

Date

MM

DD

YYYY

NAME OF AUTHORIZED PERSON

Email

Phone

(###)

###

####

ADDRESS CITY/STATE/ZIP

MOTOR VEHICLE INFORMATION

YEAR

MAKE

MODEL

COLOR

VIN

OWNER INFORMATION

MM

DD

YYYY

NAME

DRIVERS LIC#

Phone

(###)

###

####

ADDRESS CITY/STATE/ZIP

SIGNATURE (YOUR NAME)

Date

MM

DD

YYYY