VEHICLE IMPOUNDMENT REPORT
PART I - IDENTIFICATION
1. VEHICLE IDENTIFICATION
a. MAKE
b. MODEL
c. YEAR
d. COLOR
e. VEHICLE IDENTIFICATION NO.
f. VEHICLE LICENSE (1) NUMBER
(2) STATE
(3) YEAR
g. MILEAGE
h. DECAL NO.
2. REGISTERED OWNER
3. VEHICLE OPERATOR
a. NAME (Last, First, Middle Initial)
a. NAME (Last, First, Middle Initial)
b. ADDRESS (Street, Apartment Number, City, State and ZIP Code)
b. ADDRESS (Street, Apartment Number, City, State and ZIP Code)
c. ORGANIZATION
d. TELEPHONE NUMBER
c. ORGANIZATION
d. TELEPHONE NUMBER
(Include Area Code)
(Include Area Code)
PART II - DESCRIPTION
4. REASON FOR IMPOUNDMENT
5. DAMAGE TO VEHICLE
(X all that apply)
ACCIDENT
ABANDONED
a. SHADE DAMAGED AREA OF VEHICLE
EXAMPLE
BURNED
ILLEGALLY PARKED
DWI
STOLEN
OTHER (Specify)
b. X ALL THAT APPLY
Intact Missing
Intact Missing
6. CONDITION OF VEHICLE WHEN IMPOUNDED
ENGINE
BATTERY
(X all that apply)
DOOR LOCKED
DOOR UNLOCKED
MIRROR(S)
JACK
TRUNK LOCKED
TRUNK UNLOCKED
LUG WRENCH
RADIO
KEYS IN CAR
KEYS MISSING
TAPE DECK
SPARE WHEEL/TIRE
OTHER (Specify)
LR WHEEL/TIRE
RR WHEEL/TIRE
RFWHEEL/TIRE
LF WHEEL/TIRE
WHEEL COVERS
CB RADIO
7. LOCATION OF VEHICLE
8. CONDITION OF VEHICLE
(Attach additional pages if more space is needed.)
9. PERSONAL PROPERTY CONTAINED IN VEHICLE
(Attach additional pages if more space is needed.)
10. REMARKS
(Attach additional pages if more space is needed.)
PART III - DISPOSITION
11. DATE IMPOUNDED
12. TIME IMPOUNDED
(YYYYMMDD)
13. REPORTED BY
a. NAME (Last, First, Middle Initial)
b. RANK
c. DATE
14. TOWED AT
d. ORGANIZATION
e. SIGNATURE
15. STORED AT
16. WITNESSED BY
17. RELEASED BY
a. NAME (Last, First, Middle Initial)
a. NAME (Last, First, Middle Initial)
b. RANK
c. DATE
b. RANK
c. DATE
d. ORGANIZATION
e. SIGNATURE
d. ORGANIZATION
e. SIGNATURE
DD FORM 2506, MAY 2000
PREVIOUS EDITION IS OBSOLETE.
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