This Letter is provided to facilitate the claim of vehicle and/or personal property of which
is in storage at Storey Wrecker Service Inc. Fill in the blanks and have this document notarized
or witnessed whichever is applicable (note the directive at the bottom.)
I, _______________________ am the legal owner/holder by lease of one ______
_________________
print
name
year make
_______________________ with vehicle I.D. # of ___________________ & Tag
# ______________
model
issued by __________, I authorize __________________ to act as my
representative as I am not in
state print name
position to do so
myself for reason of Incarceration __, Hospitalization __, Absent by Distance
__.
I request that: The vehicle be released to the representative __,
or That only the contents be released to
the representative __, (check
those that apply.)
(X) _____________________________________________ By
my signature I release
owner - legal
signer Storey Wrecker Service
Inc.
of any and all
liabilities.
State of Oklahoma, county of ____________________.
Subscribed and sworn to before me this _______ day of ___________________
_________.
My commission expires:
____________________ (X)
____________________________
Notary
Public
+====================================================================+
(X)
_________________________________ as a staff member can witness that the person
named
print name
owner is under medical attention.
Of
__________________________________
name of
Hospital
OR
(X)
_________________________________ as a official of confinement facility I can
witness
that
the person named owner is
incarcerated.
(X)
_________________________________
name of
Facility