2. TOWING COMPANY INFORMATION
   Please fill out completely with regard to the vehicle tow.
3. 
5. SECURITY QUESTION*
   For security purposes, please enter the password provided to all towing companies by the Newport News Police which verifies authenticity. If the correct information is not entered, personnel will not complete the release.
7. Towing Company:*
   Name of towing company.
8. Caller:*
   Name of caller from company.
10. Address of Towing Company:*
11. Phone #:*
    Towing Company Phone #
13. TOW INFORMATION
15. Date and Time of Tow:*
    Date and Time of Tow:

    Date and Time of Tow:
17. Location Towed From:*
19. TOWING AGREEMENT*

    1. Illegally Parked

    1. Repossession

    With whom was the towing agreement made?
21. Name Owner/Manager/Other:
    If the tow was as the result of an illegally parked vehicle, give the name of the owner/manager/other who requested/authorized the tow.
23. Vehicle Owner Name(s):
    If the tow was as the result of a repossession, give the name(s) of the vehicle owner(s).
25. Lien Holder Name:
26. Lien Holder Phone #:
28. VEHICLE INFORMATION
30. License Plate State:
31. Tag #:
    If the tag number is not known, you must explain why. (NN Code §26-17.5)
32. Expiration Year:
34. Vehicle Identification Number (VIN):
    If the vehicle's VIN # is not known, you must explain why. (NN Code §26-17.5).
36. Vehicle Year:
37. Vehicle Make:*
38. Vehicle Model:*
40. Style/Doors:
41. Vehicle Color:*
43. Miscellaneous:
    Use this field to give any miscellaneous information regarding the vehicle.
47. NEXT SECTION TO BE COMPLETED BY NNPD ONLY
49. NNPD Employees:
    This section is only for official use. You will indicate your name, your computer #, the date of receipt, and the time received. When the information is entered into VCIN, if a different individual enters the information, note your name and computer#, the VCIN-VIC# and the date and time entered.
51. NNPD Received By:
52. Comp. #:
54. Date Information Received:
55. Time Received:
57. VCIN Entered By - Same As Above

    1. Same as Above
58. VCIN Entry Made By:
59. Comp. #:
61. VCIN-VIC#
62. Entry Date & Time:
Leave This Blank:


66. 1. Receive an email copy of this form.
67. Email address

    This field is not part of the form submission.

68. Submit Submit and Print

* indicates a required field