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, , .�. <br /> � ' , �RAIR.�ELAND TOWING,INC. CITIZEN TOWING CRITIQUE FORM <br /> 2402�NORTH WOODFORD ST. CiTY OF DECATUR-AUTHORIZED <br /> DECATUR,ILLINOIS 62526 TOWS <br /> Complete this form listing dates, times and complete wi�ess information. Deliver the <br /> completed and signed form io a representative of the towing company,and you will receive a copy <br /> for your records. <br /> CUSTOMER NAME: . <br /> CUSTONIER A.DDRESS: <br /> CL�STOMER PHONE: <br /> DATE FII,ED: / T�: <br /> DATE OF TOW: CHARGES: <br /> LOCATION OF TOW: <br /> STATEMENT <br /> ! <br /> , <br /> Signature <br /> Date and Time Received: <br /> Received By: <br /> Copies to: <br /> 1) Towing Company <br /> 2) Decatur Police Department , <br /> 3) Complainant <br /> E}��3?'T R <br />