Dd Form 2507 – Fill Out and Use This PDF

2. TO

3. FROM

3. VEHICLE IDENTIFICATION

4. LOCATION FROM WHICH VEHICLE WAS REMOVED

a. DATE REMOVED (YYYYMMDD)

b. YEAR

c. MAKE

d. MODEL

e. VEHICLE IDENTIFICATION

f. DECAL NUMBER

5. LOCATION WHERE VEHICLE IS STORED

NUMBER

g. VEHICLE LICENSE

(1) NUMBER

(2) STATE

(3) YEAR

6. YOU MAY DO ONE OF THE FOLLOWING:

OR

a. Not if y t he Inst allat ion Law Enf orcement Of f ice

b. Sign t he w aiver of int erest /release on t he back

list ed below of your int ent t o reclaim.

You must

and ret urn it w it hin 15 days of receipt of t his

not ice t o t he Inst allat ion Law Enf orcement Of f ice

show int ent t o reclaim t he vehicle w it hin 15 days

(include t he ow nership cert if icat e if in your

af t er receipt of t he not ice.

possession.

(1) INSTALLATION LAW ENFORCEMENT OFFICE

(2) INSTALLATION

LAW ENFORCEMENT OFFICE ADDRESS

TELEPHONE NUMBER

7.

AUTHORIZING OFFICIAL

a.

TYPED NAME (Last, First, Middle Initial)

b. SIGNATURE

8. VEHICLE OWNER CERTIFICATION

- I cert if y t hat I am t he ow ner of t he vehicle list ed in

-

I agree t o hold and save t he Unit ed St at es and

It em 3 .

any of it s inst rument alit ies, of f icers, or employees

- I hereby relinquish all right , t it le, and int erest t o

harmless f rom any claim or assert ion t hat may

arise w it h regard t o t he disposit ion of t he vehicle.

said vehicle now st ored at locat ion list ed in It em 5,

and expressly w aive t ime and ot her limit at ions

-

The lienholder(s) list ed below has/have (has

imposed by law and regulat ion in t he disposit ion of

not /have not ) given consent t o t his disposit ion

such propert y.

of t he propert y by signat ure below .

- I expressly w arrant t hat t here is no lien, mort gage,

-

or ot her encumbrance on t he propert y herein

I underst and t hat af t er t he execut ion of t his

abandoned as evidenced by t he enclosed cert if icat e

inst rument I am ent it led t o no f urt her not ice of

of t it le and ow ner' s regist rat ion as list ed in It em 3

any act ion or proceeding involving disposit ion of

(if applicable), except as not ed below .

t he propert y.

a. SIGNATURE OF VEHICLE OWNER

b. DATE SIGNED (YYYYMMDD)

9. THE FOLLOWING LIENS, MORTGAGES, OR ENCUMBRANCES EXIST ON THE VEHICLE LISTED IN ITEM 3.

a. FIRST LIEN, MORTAGE, OR ENCUMBRANCE

(1) NAME OF LIENHOLDER

(2) ADDRESS OF LIENHOLDER (Street, City, State, and ZIP Code)

(3) AMOUNT OF LIEN

b. SECOND LIEN, MORTAGE, OR ENCUMBRANCE

(1) NAME OF LIENHOLDER

(2) ADDRESS OF LIENHOLDER (Street, City, State, and ZIP Code)

(3) AMOUNT OF LIEN

10. LIENHOLDER CERTIFICATION

I cert if y t hat as lienholder of said propert y, I consent t o it s disposit ion in t he manner set f ort h above.

a. SIGNATURE OF LIENHOLDER

b. DATE SIGNED (YYYYMMDD)

11. NOTARY

Acknow ledged bef ore me by

at

t his

day of

,

.