Orange County Probation Unit Impoundment Verification Form
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1CORRECTIONS DEPARTMENT
COMMUNITY CORRECTIONS DIVISION
PROBATION UNIT
3723 Vision Boulevard
Reply To: Post Office Box 4970
Orlando, FL 32802-4970
ORANGE COUNTY PROBATION UNIT
Alternative
IMPOUNDMENT VERIFICATION FORM
Community
Service
Date: DATE
(407) 836-3077
Community
Name: OFFENDER NAME
Surveillance
Court Case #: CASE NUMBER
(407) 386-3057
(407) 836-0385
This is to certify that I have impounded my vehicle at ____________________________ for a
Pretrial Services
(407) 836-0370
period of _______ days in accordance with Florida Statute 316.193(6)(a)(b)(c) and as part of
(407) 836-3113
my conditions of probation.
Probation
(407) 836-3000
Owner and Vehicle Description:
Central Intake
(407) 836-3099
Registered Owner: ___________________________________________________________
Owner's current address: ______________________________________________________
City: ______________________________ State: _______ Zip: _____________________
Year/Make of Vehicle: ________________________________________________________
Model of Vehicle: ___________________________ Color of Vehicle: __________________
VIN #: _____________________________________ Tag Number: ____________________
Offender’s Signature: _______________________________________________________
To: ________________________________, the above-named offender has been ordered by
the Court to impound the above-vehicle for a term of
10 days
30 days
90 days. The
offender has selected your facility to comply with the order of impoundment. The offender
assumes all financial responsibility associated with the impoundment. During the term of
impoundment the offender SHALL NOT move nor use the vehicle in question. During the
term of impoundment the offender's Probation Officer may make a field visit to inspect the
location of said vehicle. The name and telephone number of the supervising Community
Corrections Officer is: CCO NAME, (407) 836-XXXX.
=====================================================
TO BE COMPLETED BY THE TOWING COMPANY REPRESENTATIVE
Please complete and confirm the following information:
Year/make of vehicle: _______________________ Vehicle Model: ____________________
Color of Vehicle: ________________________ Tag Number: _________________________
Vehicle VIN #: ______________________________________________________________
DATE VEHICLE WAS IMPOUNDED: _______________________________
DATE OF VEHICLE RELEASE: ____________________________________
Inspection of Vehicle information COMPLETED BY:
(Please attach business card)
Sign: _____________________________
Name (print): ______________________
Company Telephone #: _______________
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