Relocator Contract Summary Form - Wes's Service Towing

State of Illinois
Illinois Commerce Commission 527 E. Capitol Avenue, Springfield, IL 62701 217/782-4654 Fax 217/785-1448
Relocator Contract Summary Form

For validation, mail by Certified mail, return Receipt Requested.
Contract #
I am the Owner / Property Manager:
Property Address
City
County
State
ZIP Code
Phone*
Email*
I hereby authorize:
Licensed Commercial Vehicle Relocator
RTV-R #
To remove all illegally parked vehicles from:
Address:
City
County
State
ZIP Code
Which is owned by:
Property Owner
Who is located at:
Address:
City
County
State
ZIP Code
The property is:
Description of Property
This contract is a
- CALL
- PATROL
- OTHER
This property is located:
# of Miles
from the relocator's address to which the illegally parked vehicles will be routinely relocated.
The private property is in an:
- incorporated
- unincorporated
Was this private property previously under contract with another relocator:
- No
- Yes
Relocator
This contract may be cancelled only on ten (10) days notice by either party. That notice must subsequently be given to the Illinois Commerce Commission.

Authorized agent/s of the property.
Name
Name
Effective Date of the Contract
Property Owner's Name:
Signature
Date
Relocator's Name
Signature
Date
This form is required for compliance with 625 ILCS 5/18a-100 et seq.
Missing or inaccurate information will render this form invalid and it will not be accepted by the Commission.
How many states in the United States of America?*
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Comments
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