Collision Repair Facility Tow Request
Facility Shop Information
Tow request prepared by (name of person at the facility requesting tow)
Facility contact phone number
Pickup facility name
Pickup facility address (including city)
(enter email address for a copy of the form)
VIN (last 6 digits)
Facility Tow Check List
Have personals and plates been removed from vehicle?
Does the vehicle require any reassembly prior to tow?
Is claim number visible on windshield?
All keys and parts with the vehicle (example: Keys & FOBs, headlamps, modules, name plates, etc.)?
Is a flat deck required? Other considerations for the tow operator?
Is the vehicle reparable and requires a tow to a sublet repair facility?
Note: Do not select if the vehicle is a total loss.
Tow to Location
Drop-off Facility name
Drop-off facility address (including city)
Facility contact name
Facility contact number
Additional information or comments
* required fields