(Your Company Letter Head Goes Here) 

To: Tempe Police Department

Authorize (Your agent or recovery company name here) to serve and act as our agent. We authorize (Your agent or recovery company here) to take possession of a (year, make model and vehicle identification number goes here).

We agree to hold Tempe Police Department harmless from and against any and all claims, damages, losses and actions. Pursuant to ARS 28-3511 and ARS 28-3512.

(Your company name goes here) agrees not to release the vehicle to the current registered owner, if they were the driver at the time of impoundment. We understand that if we do give this vehicle to this individual prior to the 30th day, we may face possible legal sanctions.

Before we (your company name goes here), release the vehicle to the owner who was operating the vehicle at the time of removal and immobilization or impoundment, we shall require the owner to present and shall retain for a period of at least three years from date of releasing the vehicle a copy of all of the following:

1. A driver’s license issued by this state or the owners or owner’s agent state of domicile.

2. A current vehicle registration or a valid salvage or dismantle certificate of title.

3. Evidence that the vehicle is in compliance with the financial responsibility requirements of  Chapter  9, Article 4 of this title. 

Note:  This document MUST be notarized.