ASAP Lien Sales
www.asapliensales.com
asapliensales1@gmail.com
510.799.2667
Towing Lien Order Form (4 Vehicles or Less)
Please ensure the information you provide here is true and correct. All vehicles must be stored at the same storage yard. For boats please use the Private Property Lien Form located at www.asapliensales.com. For vehicles stored at different storage yards - please file those on a new form.
Business Name (Name of Tow Company)
*
Enter Business or DBA Name Here
Full Name: Must be at least 18 and authorized to file liens on behalf of the business listed above.
*
Your First Name.
Your Last Name
Business Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Is your Mailing Address the same as above?
*
Yes Its the Same
No I have a different mailing address
How many vehicles are you reporting today?
*
Please Select
1 Vehicle
2 Vehicles
3 Vehicles
4 Vehicles
Are the vehicles physically stored at the business address above?
*
Yes - The Storage Address is the Same as the Business Address
No - The vehicle(s) is/are stored at a different location.
Posted Storage Rate Per Day ($USD)
*
ie: $50.00 [This applies to all vehicles stored at the same Storage Address]
MAILING ADDRESS ONLY IF DIFFERENT FROM BUSINESS ADDRESS
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Storage Address of Vehicle (if different than business address)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Business Phone Number
*
Number of business office (must be open during
Business E-mail
*
example@example.com (Business email address)
Vehicle #1
Tell us about Vehicle #1
TYPE OF VEHICLE (#1) (MUST SELECT ONE)
*
Car, Truck, RV, Bus, Motorhome, Carrier trailer, Van, etc..
Motorcycle or ATV / OHV
Vehicle #1 Value (Please specify the vehicles current value as evaluated by your business or agency tow forms)
*
Over $4,000.00
Under $4,000.00
Vehicle #1 Year AND Make (example: 1996 Honda..)
*
ie:2004 Ford,1996 Honda. ( if unknown type: UNKN)
Vehicle #1 Model (example: Accord, Focus, etc..)
*
ie: accord, focus, model s, etc if unknown type: UNKN
VIN for Vehicle #1 (Vehicle Identification number)
The vin can be found on the vehicle. This includes motorcycles.
Motorcycle Engine # (Required) for Vehicle #1
Should be stamped on engine block. No lien sale can be done on motorcycles that do not have an engine # or if an engine change has been done)
Towing Fees for Vehicle #1
*
$$$ Towing Fees.
DATE OF POSSESION / TOWING For Vehicle #1
*
-
Month
-
Day
Year
Date of Towing or Possession
Who authorized the towing for Vehicle #1? If an agency tow please tell us which agency.
*
An agency such as Police, Sherriff, CHP or a Property Management Company
The tow was authorized by a private party but I do not have their address. Please send a Pre-Lien notice to the registered owner of record if any.
Name and City of Agency or Name and Address of Property Management Company.
ie: Oakland PD, Hayward CHP, LA PD, or Stunning Property Mgmt 12345 Notastreet Nowhere CA, 99999
Vehicle #2
Tell us about Vehicle #2
TYPE OF VEHICLE (#2) (MUST SELECT ONE)
*
Car, Truck, RV, Bus, Motorhome, Carrier trailer, Van, etc..
Motorcycle or ATV / OHV
Vehicle #2 Value (Please specify the vehicles current value as evaluated by your business or agency tow forms)
*
Over $4,000.00
Under $4,000.00
Vehicle #2 Year AND Make (example: 1996 Honda..)
*
ie:2004 Ford,1996 Honda. ( if unknown type: UNKN)
Vehicle #2 Model (example: Accord, Focus, etc..)
*
ie: accord, focus, model s, etc if unknown type: UNKN
Vehicle #2 License Plate Number and State (if none leave blank)
ie: YKW2233 CA (IF NO PLATES LEAVE BLANK)
VIN for Vehicle #2 (Vehicle Identification number)
The vin can be found on the vehicle. This includes motorcycles.
Motorcycle Engine # (Required) for Vehicle #2
Should be stamped on engine block. No lien sale can be done on motorcycles that do not have an engine # or if an engine change has been done)
Towing Fees for Vehicle #2 ($USD)
*
$$$ Towing Fees.
DATE OF POSSESION / TOWING For Vehicle #2
*
-
Month
-
Day
Year
Date of Towing or Possession
Who authorized the towing for Vehicle #2? If an agency tow please tell us which agency.
*
An agency such as Police, Sherriff, CHP or a Property Management Company
The tow was authorized by a private party but I do not have their address. Please send a Pre-Lien notice to the registered owner of record if any.
Name and City of Agency or Name and Address of Property Management Company.
ie: Oakland PD, Hayward CHP, LA PD, or Stunning Property Mgmt 12345 Notastreet Nowhere CA, 99999
Vehicle #3
Tell us about Vehicle #3
TYPE OF VEHICLE (#3) (MUST SELECT ONE)
*
Car, Truck, RV, Bus, Motorhome, Carrier trailer, Van, etc..
Motorcycle or ATV / OHV
Vehicle #3 Value (Please specify the vehicles current value as evaluated by your business or agency tow forms)
*
Over $4,000.00
Under $4,000.00
Vehicle #3 Year AND Make (example: 1996 Honda..)
*
ie:2004 Ford,1996 Honda. ( if unknown type: UNKN)
Vehicle #3 Model (example: Accord, Focus, etc..)
*
ie: accord, focus, model s, etc if unknown type: UNKN
Vehicle #3 License Plate Number and State (if none leave blank)
ie: YKW2233 CA (IF NO PLATES LEAVE BLANK)
VIN for Vehicle #3 (Vehicle Identification number)
The vin can be found on the vehicle. This includes motorcycles. AKA VIN NUMBER.
Motorcycle Engine # (Required) for Vehicle #3
Should be stamped on engine block. No lien sale can be done on motorcycles that do not have an engine # or if an engine change has been done)
Towing Fees for Vehicle #3
*
$$$ Towing Fees.
DATE OF POSSESION / TOWING For Vehicle #3
*
-
Month
-
Day
Year
Date of Towing or Possession
Who authorized the towing for Vehicle #3 ? If an agency tow please tell us which agency.
*
An agency such as Police, Sherriff, CHP or a Property Management Company
The tow was authorized by a private party but I do not have their address. Please send a Pre-Lien notice to the registered owner of record if any.
Name and City of Agency or Name and Address of Property Management Company.
ie: Oakland PD, Hayward CHP, LA PD, or Stunning Property Mgmt 12345 Notastreet Nowhere CA, 99999
Vehicle #4
Tell us about Vehicle #4
TYPE OF VEHICLE (#4) (MUST SELECT ONE)
*
Car, Truck, RV, Bus, Motorhome, Carrier trailer, Van, etc..
Motorcycle or ATV / OHV
Vehicle #4 Value (Please specify the vehicles current value as evaluated by your business or agency tow forms)
*
Over $4,000.00
Under $4,000.00
Vehicle #4 Year AND Make (example: 1996 Honda..)
*
ie:2004 Ford,1996 Honda. ( if unknown type: UNKN)
Vehicle #4 Model (example: Accord, Focus, etc..)
*
ie: accord, focus, model s, etc if unknown type: UNKN
Vehicle #4 License Plate Number and State (if none leave blank)
ie: YKW2233 CA (IF NO PLATES LEAVE BLANK)
VIN for Vehicle #4 (Vehicle Identification number)
The vin can be found on the vehicle. This includes motorcycles.
Motorcycle Engine # (Required) for Vehicle #4
Should be stamped on engine block. No lien sale can be done on motorcycles that do not have an engine # or if an engine change has been done)
Towing Fees for Vehicle #4
*
$$$ Towing Fees.
DATE OF POSSESION / TOWING For Vehicle #4
*
-
Month
-
Day
Year
Date of Towing or Possession
Who authorized the towing for Vehicle #4 ? If an agency tow please tell us which agency.
*
An agency such as Police, Sherriff, CHP or a Property Management Company
The tow was authorized by a private party but I do not have their address. Please send a Pre-Lien notice to the registered owner of record if any.
Name and City of Agency or Name and Address of Property Management Company.
ie: Oakland PD, Hayward CHP, LA PD, or Stunning Property Mgmt 12345 Notastreet Nowhere CA, 99999
FINAL REVEIW AND SUBMISSION
Please review the above information for errors before submitting.
You understand that by submitting this form you are authorizing ASAP LIEN SALES to file lien sale documents with the CA DMV on your behalf using the information you have provided. You agree that you are authorized to file liens on behalf of the business listed on this form. You agree to defend, indemnify, and hold harmless ASAP LIEN SALES and all associated agents from any lawsuits, judgements, omissions or errors of any kind and under any circumstances. You agree to have a valid lien on the vehicle/vessel pursuant to California laws. You understand that ASAP LIEN SALES does not and can not provide legal advice in any way.
*
I Understand and Agree
Sign Name (type First and Last Name)
*
Enter Todays Date
*
-
Month
-
Day
Year
Todays Date
Submit
Should be Empty: