Form Dlr-430-503 "Unauthorized Vehicle Impoundment Report" - Washington

Form DLR-430-503 is a Washington State Department of Licensing form also known as the "Unauthorized Vehicle Impoundment Report". The latest edition of the form was released in November 1, 2014 and is available for digital filing.

Download a PDF version of the Form DLR-430-503 down below or find it on Washington State Department of Licensing Forms website.

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Unauthorized Vehicle Impoundment Report
License number
State
Vehicle Identification Number (VIN)
Make
Model
Year
1. To be communicated orally immediately to the law enforcement agency having jurisdiction.
2. Send in writing within 24 hours of impoundment to law enforcement agency jurisdiction.
To:
This is notice that the undersigned towing firm impounded the vehicle described above at:
Street address
City/Town
Date of impoundment
Time of impoundment
Time of radio/telephone call to law enforcement agency having jurisdiction
a.m.
p.m.
a.m.
p.m.
Name of towing firm
Street address
City
State
ZIP code
Firm’s authorized agent
(Area code) Business phone number
(Area code) Fax number
DLR-430-503 (R/11/14)WA
Click here to START or CLEAR, then hit the TAB button
Unauthorized Vehicle Impoundment Report
License number
State
Vehicle Identification Number (VIN)
Make
Model
Year
1. To be communicated orally immediately to the law enforcement agency having jurisdiction.
2. Send in writing within 24 hours of impoundment to law enforcement agency jurisdiction.
To:
This is notice that the undersigned towing firm impounded the vehicle described above at:
Street address
City/Town
Date of impoundment
Time of impoundment
Time of radio/telephone call to law enforcement agency having jurisdiction
a.m.
p.m.
a.m.
p.m.
Name of towing firm
Street address
City
State
ZIP code
Firm’s authorized agent
(Area code) Business phone number
(Area code) Fax number
DLR-430-503 (R/11/14)WA
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