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Abandoned Vehicle Report

2. Location of Problem

   Please provide exact address or street with block range or street with nearest cross street.

4. Vehicle Make

   Remember the more detail you provide, the better of a chance we will have to take action.

5. Vehicle Model

   Remember the more detail you provide, the better of a chance we will have to take action.

6. License Plate of Vehicle

   Remember the more detail you provide, the better of a chance we will have to take action.

7. Vehicle Color

   Remember the more detail you provide, the better of a chance we will have to take action.

9. A Brief Description of the Problem*

   Remember the more detail you provide, the better of a chance we will have to take action.

11. First Name

12. Last Name

14. Email Address

15. Phone Number

17. Picture of the Vehicle (Including License Plate)

    Remember the more detail you provide, the better of a chance we will have to take action.

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18. 1. Receive email copy
19. Email address

    This field is not part of the form submission.

20. Submit

* indicates a required field