Request For Tow Hearing Form (Page 3 of 3) in pdf

(Please check the appropriate information)

_____ I paid the costs of the tow and storage in the amount of $________________.

_____ I received a receipt for payment from the Towing Company or the Vehicle Storage Facility

_____ I received notification of my rights following the removal of the Vehicle from the Vehicle Storage

Facility.

_____ I have attached a copy of the receipt and/or of the notification of rights to this Request for Hearing.

_____ If the Vehicle was removed from a parking facility, I have attached photograph(s) that show the

location text of signs posted restricting the parking of vehicles at the parking facility.

_____ No notice of rights following the towing and storage of the Vehicle was given to me by the towing

the Vehicle Storage Facility

_____ No signs restricting parking were posted at the parking facility

_____ I was charged or paid a towing charge greater than the amount authorized. I paid a Towing Charge

of $ ________________

Signed on: _______________________________

________________________________________

Signature or Owner/Operator of Vehicle

________________________________________

Printed Name of Owner/Operator of Vehicle

*************************************************************************************************************************

Notice of Hearing Date, Time and Location

YOU ARE NOTIFIED that a hearing is scheduled on: _____________________ at ___________ am/pm

In JUSTICE OF THE PEACE, PRECINCT ______, PLACE _____, LIBERTY COUNTY, TEXAS

AT ______________________________________________, ____________________, TEXAS _______.

SIGNED this ________ day of ________________________, 20 _______ .

________________________________________

Judge Presiding

Date Notice sent via Certified Mail, RRR, Restricted Delivery or via fax:

___________________________________________________________

Person who requested the hearing

___________________________________________________________

Person/Law Enforcement Agency that authorized the removal of vehicle

___________________________________________________________

Vehicle Storage Facility in which the vehicle was placed

Request For Tow Hearing Form Page 3