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Vehicle Release Form

Please complete and submit the Vehicle Release Form below to authorize the release of your vehicle to a third party.

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This field is for validation purposes and should be left unchanged.
Vehicle Owner Information
Name*
Email*
Phone*
Driver's License #*
Driver's License Photo*
Please upload a clear photo of your driver's license.
Drop files here or

Accepted file types: jpg, jpeg, gif, png, pdf, heic, Max. file size: 6 MB.
Address*
Street Address City State ZIP Code
Motor Vehicle Information
Year*
Make*
Model*
Color*
VIN #*
Vehicle Registration Photo*
Please upload a clear photo of your vehicle's registration.
Drop files here or

Accepted file types: jpg, jpeg, gif, png, pdf, heic, Max. file size: 6 MB.
Authorized Person/Company
Name of Authorized Person or Insurance Company*
Phone*
Claim Number (if applicable)
Address*
Street Address City State ZIP Code
Acknowledgement
I hereby certify that I am the legal owner of the above listed motor vehicle, and thus authorize the release of said vehicle to the above specified Authorized Person(s) and/or insurance company, and/or agent thereof.
Vehicle Owner Signature*
Your information is processed securely, and is never shared, distributed, or sold to any third parties. By providing a telephone number and submitting the form you are consenting to be contacted by voice or SMS text message. Message frequency may vary. Message & data rates may apply. Reply STOP to opt-out, Reply HELP for more information.