Illinois Administrative Code
Title 92 - TRANSPORTATION
Part 1470 - NON-RELOCATION TOWING
Subpart H - TRANSPORTATION AT OWNER'S REQUEST
Exhibit A - Written Authorization to Tow Form
1) I, __________________, am the owner or owner's agent (spouse, child, brother, sister, parent, attorney or court appointed legal representative ONLY may be considered to be owner's agent) of the following vehicle:
2) __________________________________________________________________________________
Make Model Year
______________________________________________________________________________________
VIN #
______________________________________________________________________________________
License Plate # (Include State)
3) My address is:
______________________________________________________________________________________
Street
______________________________________________________________________________________
City State Zip Code
4) This authorization is hereby given to ____________________ of__________________
__________________________________________ , to tow the vehicle described above.
5) I hereby state and affirm, under oath, that I am the duly authorized owner or owner's agent of the vehicle described above.
Date: ______________________ Signature: _____________________________
Instructions - Written Authorization to Tow Form
All parts of this form must be legible, in ink or typewritten, and completely filled out.
Line 1 - Fill in your complete name. Note that only certain persons may qualify as owner's agent.
Line 2 - Give make, model and year of vehicle being towed. Also include VIN (Vehicle Identification Number) number and license plate number (including state).
Line 3 - Provide your complete mailing address.
Line 4 - Fill in full name of person towing the vehicle and complete mailing address.
Line 5 - Sign in ink and date. Note that the permission you provide in this form is under oath.
Special Note: Other State and local requirements concerning proof of ownership and identification of owner or owner's agent may have to be met before the vehicle may be released.
