TAKERS Tow Authorization Form

(Private Property Impound Request – Kansas)

Vehicle Information

Vehicle 1:

Vehicle 2:

Vehicle 3:

Vehicle 4:

Vehicle 5:

Vehicle 6:

Providing any one of these documents expedites processing and removal of the vehicle -

Notice to Tow

Property Violation Notice

Photo of Violation (e.g., vehicle in reserved spot, blocking access, etc.)

Other Official Documentation

Authorized Property Owner/Manager

I, the undersigned, am the lawful owner, authorized manager, or designated representative of the property listed above, and I affirm that I have full authority to authorize the removal of vehicles from this property. I hereby grant TAKERS, INC. permission to tow and remove the vehicle described herein from my property in accordance with all applicable Kansas laws governing unauthorized parking and private property towing. I certify that the vehicle is parked without authorization, in violation of property rules, or in a manner that obstructs access, safety, or operations on the premises.

By signing this form, the signer affirms under penalty of perjury that they are authorized to request this tow. TAKERS, INC. reserves the right to verify the authority of the signer before proceeding. Any falsification or misrepresentation may result in legal action.