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TEXAS DEPARTMENT OF LICENSING AND REGULATION COMPLIANCE DIVISION/Tow Truck/Vehicle Storage Program P.O. Box 12157, Austin TX 78711 Email:
[email protected] Website Address: www.tdlr.texas.gov 800/299-1700 SPECIFIC POWER OF ATTORNEY Retrieval of Motor Vehicle by Lien Holder The undersigned representative of ___________________________, (the Company) with it principle place of business at __________________________________________ (street address, city and state) do hereby swear or certify that the Company is the owner of the motor vehicle described herein. The Company establishes ownership of the vehicle under an: ___ unrecorded lien holder with a right of possession, or ___ lien holder with an affidavit of repossession (a copy of which is attached hereto) to the following described motor vehicle: Vehicle Year, Make and Model: __________________________ Vehicle Identification Number: __________________________ State of Registration: __________________________________ As the authorized representative of the Company, I further swear or certify that ____________________________, towing company, TDLR license # _______________ is appointed as the Company’s lawful attorney-in-fact (referred to as “the Agent”) on the following terms and conditions: 1) Authority to Act. The Agent is authorized to act for me under this Specific Power of Attorney as described herein. Powers of Agent. The Agent may act and exercise power, authority and control on my behalf, with regard to the motor vehicle described herein. The authority granted herein is limited to making payment to and obtaining release of the referenced vehicle from _____________________________________ (name of Vehicle Storage Facility). 2) Durability. This Specific Power of Attorney shall expire the earlier of three (3) days from its date of execution, or at an earlier date if revoked by me in writing, or when the motor vehicle is in the possession of the Company. Signed this ___ day of _________________, 20___. __________________________________ Printed Name of Representative and Title
________________________________ Signature of Authorized Representative
Subscribed and sworn to before me on this ___ day of _________________, 20___. Notary Public, State of ___________ My commission expires: _____________
This is a legal document and is provided as a courtesy free of charge. This document affects your legal rights and may give others access to you motor vehicle. If you do not understand this document or have questions, please consult an attorney. Blank lines render this form invalid and of no consequence.
