Release to Insurance

Authorization To Release Vehicle

"*" indicates required fields

Name*
MM slash DD slash YYYY
*This Authorization to Release Vehicle is valid for Thirty (30) Days after signed date
Max. file size: 256 MB.
Max. file size: 256 MB.
I authorize Weil Wrecker Service to release the above listed vehicle to:
MM slash DD slash YYYY
This field is for validation purposes and should be left unchanged.
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