OFFICE USE ONLY
Received
Returned
State Of Tennessee, Department Of Revenue
Taxpayer and Vehicle Services Division
Vehicle Services Section
44 Vantage Way, Suite 160
Nashville, TN 37243-8050
Phone: (615)741-3101 Fax: (615)253-4259
Toll-Free: (888)871-3171
REQUEST FOR VERIFICATION OF OWNERSHIP: VEHICLES FOUND ABANDONED/IMMOBILE OR UNATTENDED
Note: A fee of $1.00 must be submitted with this form
PART A: REQUESTING PARTY AND VEHICLE INFORMATION
( )
Company Name Telephone Number
Applicant’s Name
Street Address
Mailing Address – If different from street address
City State Zip
Date Storage Began: (Attach Copy of Law Enforcement Towing Form; if not available, attach explanation.)
YEAR MAKE MODEL VEHICLE IDENTIFICATION NUMBER LICENSE PLATE STATE
**MUST FURNISH VERIFICATION OF VEHICLE IDENTIFICATION NUMBER WITH THIS REQUEST**
If available, please list the vehicle’s plate number and state of issue.
Tennessee Code Annotated, Section 55-16-105 et seq.: A TENNESSEE LAW ENFORCEMENT AGENCY shall verify ownership information through the Tennessee
Enforcement System (TIES) for processing by the police agency or any towing company contracting with the police agency. Any response not on file with the TIES system
and queries made by persons other than a police agency or towing firm shall be referred to the Tennessee Department of Revenue, Taxpayer and Vehicle Services Division.
All lienholders and owners must be notified by certified mail, return receipt requested, within three (3) business days from receiving verification of ownership of such vehicle.
TAXPAYER AND VEHICLE SERVICES USE ONLY
FOR NCIC USE ONLY
NOTE: Per Tenn. Code Ann. § 55-16-102, persons failing to submit notification within (10) days after the termination of the thirty (30) day period forfeit all
claims for storage or parking of such vehicle and commit a Class C misdemeanor. Each day's FAILURE to report is a separate offense.
Signature “I certify that all information is true and correct”
Date
Notice of thirty (30) day storage must be made by completing PART B on the reverse side. Submit this form to the Taxpayer and Vehicle Services Division of the
Tennessee Department of Revenue by U.S. mail at the address indicated above. For faster service, you may fax Part B of this form to (615) 253-4259.
RV- F1310601 (Rev. 1/2011)
