Vehicle Property Release Form printable pdf download

Walton County Recovery

635 Old Jolly Bay Rd

Freeport, Fl. 32439

Vehicle Property Release Form

I, _________________________________________________, am the legal and rightful owner of the below listed

motor vehicle presently stored on the property owned and operated by Walton County Recovery, and thus authorize

the personnel of said company to release said property to the following person(s) and/or insurance company, and/or

agent thereof:

NAME: (

) ___________________________________________________________

authorized person

ADDRESS: _________________________________ CITY:________________________________

STATE: ______ZIP CODE: _________ PHONE: ____________________ CLAIM# ___________

MOTOR VEHICLE INFORMATION:

YEAR: _________ MAKE: __________________________ MODEL: _______________________

COLOR: ______________________ VIN# _____________________________________________

OWNER INFORMATION:

NAME: _____________________________ DRIV LIC# _______________________ STATE: ____

ADDRESS: ____________________________ CITY:______________________ STATE: _______

ZIP CODE: _____________ PHONE: _________________________ PHONE: ________________

Description of property to be released: __________________________________________________

_________________________________________________________________________________

Furthermore, I understand that in the event that the aforementioned property is to be released to an individual

person, that person will be required to present a “valid” photo identification card that must be in one of the

following forms: 1) Any U.S. state issued driver license, 2) Any U.S. state issued personal identification card,

3) U.S. Military identification card or, 4) US Government Issued Passport, with Photo.

NOTICE:

VEHICLE OWNER

A copy of your driver’s license and motor vehicle registration card, certificate, or title MUST accompany this

form. In the event that the owner is authorizing this release from either a hospital bed, or while being

detained in any prison and/or jail, he/ she must have this form signed and witnessed by a legally

certified/commissioned Notary Public (see below).

X___________________________________________

DATE: _____/_____/________

MOTOR VEHICLE OWNER’S SIGNATURE:

___________________________________________________________________

MY COMMISSION EXPIRES ON:

NOTARY PUBLIC – SIGNATURE

________ / ________ / ___________

___________________________________________________________________

[ ] Personally Known, OR

NOTARY PUBLIC – PRINT NAME

[ ] Produced Identification; Type:

(NOTARY STAMP / SEAL)

_______________________________________

Vehicle Property Release Form

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