Briefly describe the abandoned vehicle that is located on the street. Describe how long it has been at the location, does it have current tags, is it known to be in working order.*

Location of Abandoned Vehicle (in front of which address)

Street Number and Name:*

*

Address Line 2:

City:*

State:*

Zip Code:

Your Information

Name:

Street Number and Name:

Address Line 2:

City:

State:

Zip Code:

Phone Number:

Fax Number:

Email Address:

Preferred Contact Method:*

Do NOT contact me Email