PPI Authorization

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Once Your Form Is Completed, You Will See A Pop-Up Message That Says...
'Your PPI Form Was Sent!'

If You Do Not See That Message, Then You Are Missing One Or More Form Fields.
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Please Fill Out All Fields For Your Request

Referral ^*

Please Enter How or Who Referred You To Us...

Google? Tow Company? Other Media? Friend? Repeat or New Customer? Repair Shop? Family? Etc...

Private Property Impound & Tow Authorization ^*

I am in legal control of listed property, and I do hereby authorize 'Schaefer Transport & Asset Recovery, LLC', or Dba: 'STAR TOWING', a Utah based company, whose office/yard space is located at the following address. '978 North 1540 West, Orem, Utah 84057', and the company Mobile Office number is '(801)-471-7444', to remove this listed vehicle or item from the following listed private property address, immediately and with reasonable care.

I am legally vouching to be the owner of the private property, agent or representative of the private property, with permission of the actual private property owner(s), or are a legally contracted leaser of the private property, or are in legal control of the private property, to consent and approve the private property impounding services.

SHHA Authorization: I hereby, as Owner, Leaser, Agent or Representative, in consideration of the above-named towing company and driver providing service(s), release and hold harmless of any liability, the above-named towing company and all employees or drivers of said company. I understand that such service(s) involves possible risk of damage to the vehicle and.or private property, and do hereby expressly accept all those risks, damages to impounding vehicle / private property and incurred costs, legal or otherwise.

SHHA Authorization: Your signature below acknowledges, releases and holds harmless, the above-named towing company and any of its employees or drivers, from any liability resulting from the service(s) provided and/or towing of the vehicle or item, and your signature is testimony that you have read and understand this statement of 'Release of Liability', and have no questions or concerns whatsoever, at the time of the 'PPI Form' filing and/or the service(s) provided by the above-named towing company.

I understand what PPI (Private Proerty Impound) means, and what SHHA (Service Hold Harmless Agreement) means.

I understand that this form is protected by a 'SSL Certificate' (Secure Sockets Layer) for privacy and encryption of data.

Please acknowledge all of the following agreements, acknowledgements or authorizations, by checking 'All Boxes' listed in this section above.

Private Property Impound Charges or Release Of Possession Interests ^*

Option Does Not Apply

I wish to pay for all charges incurred for the 'Abandoned' Private Property Impound (PPI) to STAR TOWING, so that I may keep the PPI vehicle or item for myself.

I wish to release the 'Abandoned' Private Property Impound (PPI) vehicle or item to STAR TOWING, and decline any interest in keeping the PPI vehicle or item for myself..

Please choose which option best fits your interests in the 'Private Property Impound' for the 'Abandoned' vehicle or item only.
If this Private Property Impound is 'Not Abandoned', and this vehicle or item is being towed for other reasons, please select the 'Option Does Not Apply' to the form field.

Reason For Private Property Impound ^*

One of these reasons above needs to be notated with the impounding of the vehicle to the State of Utah DMV system.
If vehicle is being removed because the vehicle was 'Abandoned', Please make sure you have contacted the local police department to verify that the vehicle is not 'Stolen' or involved in any crime(s) with an 'NCIC' check, before removal.

Local PD That Verified On Stolen & NCIC Check

If you selected 'Abandoned' above, please fill this form field. (Otherwise leave form field empty)
Name of the local police department that verified the vehicle was not 'Stolen' or did the 'NCIC system check.

Date The Local PD Verified On Stolen & NCIC Check

If you selected 'Abandoned' above, please fill this form field. (Otherwise leave form field empty)
Date that the local police department verified the vehicle was not 'Stolen' or did the 'NCIC system check.

Time Vehicle Has Been On Private Property (Prior) ^*

One of these time frames above needs to be notated with the impounding of the vehicle to the State of Utah DMV system.

Photos of Private Property Impound? ^*

This information needs to be noted with the impounding of the vehicle to the State of Utah DMV system, and the towing companies paperwork filing system.
If you have screen shots, pictures or video, you can send them directly to us.

To send us those files easily...
Please send them one at a time for ease of use.
Click here for MOBILE MESSAGING.
Click here for MOBILE EMAIL or PC EMAIL.

Actual Private Property Owner or Business Name ^*

Please enter the 'Actual Private Property Owner' name or business name, regardless if you are an Owner, Agent, Representative, Leaser or Power of Attorney.

Actual Private Property Owner or Business Phone ^*

Please enter the 'Actual Private Property Owner' phone or business phone, regardless if you are an Owner, Agent, Representative, Leaser or Power of Attorney.
Please enter the phone number with dashes.
(Ex: 801-471-7444)

Actual Private Property Owner or Business Email ^*

Please enter the 'Actual Private Property Owner' email or business email, regardless if you are an Owner, Agent, Representative, Leaser or Power of Attorney.
(Ex: example@startowingutah.com)

Who Are You In Relation To The Private Property? ^*

Choose which person you are that has legal control in this private property impound service.

Owner, Leaser, Agent or Representative Name ^*

You are legally vouching to be the owner of the property, or an agent/representative of the property, with permission of the actual property owner(s), or are a legally contracted leaser of the private property, or are in legal control of the private property, to consent and approve the private property impounding services.

Owner, Leaser, Agent or Rep Drivers License Number ^*

Private Property Owner, Leaser, Agent or Representative drivers license number, for legal reasons, digital signature verification and tracking purposes for towing company and/or the State of Utah DMV.
We will need to verify your physical drivers license in person, via email or via text mobile message.

Owner, Leaser, Agent or Rep Drivers License State ^*

Private Property Owner, Leaser, Agent or Representative drivers license state, for legal reasons, digital signature verification and tracking purposes for towing company and/or the State of Utah DMV.
We will need to verify your physical drivers license in person, via email or via text mobile message.

Owner, Leaser, Agent or Representative Phone ^*

Private Property Owner, Leaser, Agent or Representative phone number, for contacting purposes for towing company and/or the State of Utah DMV.
Please enter the phone number with dashes.
(Ex: 801-471-7444)

Owner, Leaser, Agent or Representative Email ^*

Private Property Owner, Leaser, Agent or Representative email, for contacting purposes for towing company and/or the State of Utah DMV.
(Ex: example@startowingutah.com)

Private Property Address or Location ^*

Address or Location of the vehicle being impounded.
Please give us address, city and zipcode...
You can use Latitude & Longitude as location if needed...
(Ex: 40.3149018, -111.7326056)

Private Property Classification or Business Name ^*

Please give us the classification of the private property or the actual business name.
(Ex: Residential, Church, Apartment, Storage, Etc.)
(Ex: Starbucks Coffee, LDS Church, Joe's Storage, Etc.)

Year Of Vehicle Being Impounded ^*

Year of the vehicle being impounded.

Make Of Vehicle Being Impounded ^*

Make of the vehicle being impounded.

Model Of Vehicle Being Impounded ^*

Model of the vehicle being impounded.

Color Of Vehicle Being Impounded ^*

Color of the vehicle being impounded.

Type Of Vehicle Being Impounded ^*

Type of vehicle being impounded.

Type Of Drivetrain On Vehicle Being Impounded ^*

Type of drivetrain on the vehicle being impounded.

Type Of Item Being Impounded ^*

Type of item being impounded.

Will It Roll? ^*

Will the vehicle or item roll that is being impounded.

Vehicle or Item Length Being Impounded ^*

Enter the length of the vehicle/item being impounded.
This does not include Standard Cars or Trucks, select the 'OPTION DOES NOT APPLY'.
(Examples: Manufacturing Equipment, Container, Box or Cube, Shed, Misc, Construction Equipment, Utility Truck, Box Truck or Trailer Type of any kind.)
If the vehicle/item is not described in any of these above in the 'Examples', then select in the form field, the 'OPTION DOES NOT APPLY'.

Vehicle Being Impounded Towing A Trailer? ^*

Indicate if the vehicle being impounded is towing a trailer or has one attached.
If you selected 'YES', then you will need to fill out an 'ADDITIONAL FORM' for the trailer, along with the vehicle being impounded. (After completing this form...)
If it is only a trailer being impounded with out a vehicle, please say 'NO' to this option, and put your information above and below in the vehicle/item question sections.

What Type Of Trailer Being Impounded? ^*

What type of trailer is being impounded?

Plate State Of The Vehicle Being Impounded ^*

Select the state plate or registration tag of the vehicle being impounded is registered.
If there is a 'Temporary Registration Tag', please select the 'TEMP TAG STATE' from which it is registered.

Plate or Tag Number Being Impounded ^*

Enter the 'License Plate', 'Registration Tag' of the vehicle/item being impounded.
You can also enter the item 'DATA PLATE' or the 'SERIAL PLATE' of the item here.
If there is a 'Temporary Registration Tag', please select the 'TEMP TAG NUMBER' in this form field.

VIN or HIN (Hull) ^*

VIN or HIN (Hull) of the vehicle/item being impounded.
Must be the full 17 Digits listed on the vehicle tag.
Vehicle: Located on the bottom driver side corner of the windshield, or inside the driver side door trim, or the inside edge of the driver side door itself.
Boats: Located on the rear transom in the upper right corner, gunwale on upper edge, hull/deck joint is usually which ever is lowest.
You can also enter the item 'DATA PLATE' or the 'SERIAL PLATE' in this form field here.

Personal Presence of Service(s) ^*

Personal presence of the service(s), for the vehicle/item being impounded.

Key(s) Present? ^*

Is there a key(s) for the vehicle/item being impounded.

Notes, Reason(s) & Description Of Location For Private Property Impound Service(s) ^*

Your Special Notes About Private Property Impound Service(s).
Reason(s) For Private Property Impound Service(s)...
Describe Location If Needed... Direction Details, Parking Lot, Garage, Parking Garage Level, Direction Facing (North/South/East/West), Parking Space or Unit Number, Field, Indoor or Outdoor, Etc...

Digital Acknowledgement Signature ^*

Please use your complete full name.
(Ex: John Turner Doe = First, Middle and Last)
Your digital signature here is considered legal and contractually binding.
Please enter your signature, whether you are an Owner, Agent, Representative, Leaser or Power of Attorney.

Digital Acknowledgement Signature Date Of Signing ^*

Digital acknowledgement signature date of signing.
(Ex: 8-24-2014 or 8/24/2014)

Digital Acknowledgement Signature Time Of Signing ^*

Digital acknowledgement signature time of signing.
(Ex: 11:59AM or 11:59 AM)

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