Form Dlr 430 506 – Fill Out and Use This PDF

Right of Redemption and

Opportunity for a Hearing Notice

Beginning July 28, 2013, you must use this form and attachments if you want to redeem an impounded vehicle, want access to an impounded vehicle, or want to request a hearing in the matter. When completed, file this form with the district / municipal court in the county where the vehicle was impounded.

As the person or business seeking to redeem an impounded vehicle, you are hereby notified that you have certain statutory rights and obligations as set forth in RCW 46.55.

•You have the right to request a hearing in district/municipal court to contest the validity of the impound and/or the towing and storage fees. Your request for a hearing must be received by the district/municipal court within 10 days of this date. Attached is a hearing request form.

•If you choose to request a hearing, all funds paid to redeem your vehicle will be held in a trust account pending the disposition of that hearing.

•You have the right to receive a copy of the towing and storage receipt. Attached is a copy of that receipt.

•You have the right to know the name of the person or agency authorizing the impound. This information is attached.

Vehicle information

Person or business seeking to redeem the vehicle

Name

Street address

(Area code) Telephone number

Acknowledgment

As the person, vehicle insurer or a vendor working on behalf of the vehicle insurer seeking to redeem an impounded vehicle, I acknowledge receipt of this written notice of rights in redeeming the vehicle. I understand that I have the right to request a hearing in district/municipal court and have received a form to make such a request. I have received a copy of the towing and storage receipt, the name of the person or agency authorizing the impound, and I acknowledge that this Right of Redemption and Opportunity for a Hearing form will serve as a receipt for the vehicle.

a.m.	X
p.m.
Date and time		Signature

Person or business seeking access to the vehicle or vehicle information

If you are seeking to retrieve personal belongings from the vehicle, view the vehicle to determine the extent of damage, or request any information in regards to the vehicle, please complete this section.

	Purpose
	Retrieve personal belongings	View the vehicle			Request information on the vehicle
	Name
	Street address
	City					State	ZIP code
	(Area code) Telephone number
	Acknowledgment
		a.m.	X
		p.m.
	Date and time			Signature