1 South Station, 5
th
Floor • Boston, MA 02110 • Tel: (617) 305-3559 • Fax: (617) 478-2598 • Email: DPU.Transportation@mass.gov
Annual Tow Report
Please note: a filing fee of $10 is required to process this tow report.
The Department now accepts payments online. Please visit our website for more information:
mass.gov/how-to/pay-transportation-oversight-division-fees
If your company did not perform any regulated tows in 2017, your company must submit a signed letter to the
Department on company letterhead certifying no regulated tows along with the $10 filing fee.
Please enter the total number of tows your company performed for the period of 1/1/2017 through 12/31/2017
POLICE ORDERED TOWS
Total POLICE ORDERED TOWS Performed from 1/1/17 through 12/31/17
TRESPASS TOWS
Total TRESPASS TOWS Performed from 1/1/17 through 12/31/17
Total DPU Regulated TOWS from 1/1/17 through 12/31/17
STORAGE
Total Number of DAYS BILLED FOR FENCED LOCKED STORAGE
Total Number of DAYS BILLED FOR UNGATED STORAGE
Total Number of VEHICLES STORED
REVENUE
Total Revenue for Police Ordered Tows
Total Revenue for Trespass Tows
Total Revenue for Outside Contractor
Total Revenue for Extra Man Hours
Total
Department of Public Utilities
Transportation Oversight Division
Please note: a $10 filing fee is required to process this report.
Reports will not be processed without payment.
The Transportation Oversight Division now accepts payments
online. You can also submit a check or money order by mail.
Please see our website for more information:
mass.gov/how-to/pay-transportation-oversight-division-fees
Using Adobe Acrobat or Reader to fill out this report? Click the red
button below to submit your report by email. You can also save this
PDF and submit it as an email attachment to:
DPU.Transportation@mass.gov
You can also print and submit this application by mail to the
Transportation Oversight Division. The Division’s mailing address
can be found at the top of this form. Please be sure to pay online
or submit a check/money order with your report.
THE FOLLOWING STATEMENT IS MADE UNDER THE PENALTIES OF PERJURY:
I, the undersigned, declare that I have examined this form and to the best of my knowledge and belief it is true, correct, and
complete, and I further declare that I have authority to sign this document on behalf of the Company.
Signature: Date: Carrier Name:
Title: Certificate Number:
I'm sending a check/money order
I'm paying online
(Type full, legal name)
