Vehicle Removal Written Authorization Form - Zip Tow

40-0206 R02/15 azdot.gov

Mail Drop 553M
Abandoned Vehicle Unit
PO Box 2100
Phoenix AZ 85001-2100

VEHICLE REMOVAL
WRITTEN AUTHORIZATION

I am the owner or lessee of the property at the physical address stated below and hereby authorize the following
individual or company to remove the vehicle described below from that property. I have no interest in the vehicle.

Property Owner or Lessee Name*
Physical Address Where Vehicle is Located*
Street Address City County
Removal Authority Given To (company or individual name)
Property Owner or Lessee Signature*
Date*
MM slash DD slash YYYY
Vehicle Identification Number
License Plate Number*

If vehicle has no license plate please type NONE
Vehicle Year
Make*
Model
Color*
Mailing Address
Street Address City State ZIP Code