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� , . <br /> , . <br /> PRAIRIELAND TOWING, INC. <br /> RELEASE REQUEST FORM-PERSONAL PROPERTY IN VEHICLE <br /> Nazne of Claimant: <br /> Address of Claimant: <br /> / <br /> Telephone Number of Claimant: <br /> The claimant hereby states and affirms that he/she is lawfully entitled to immediate <br /> possession of the personal properiy described herein which is located in an automobile towed and/or <br /> stored by Prairieland Towing,Inc.,an Illinois corporation("Prairieland'�,pursuant to Decatur Police <br /> Department authority. Said claimant hereby covenants,wazrants and agrees that he/she will defend, <br /> indemnify and hold harmless Prairieland, and all directors,officers, employees and agents thereof, <br /> from any loss, Iiability, demand, action, suit, atlegation, assertion,damage, injury, claim or cost or <br /> expense,including reasonable attomey's fees,asserted,alleged,advanced or clairned by any person <br /> or entity having any actual or claimed interest or right in the personal property released to claimant <br /> by Prairieland or any right of possession thereof. <br /> The personal property requested by the claimant for release is described as follows: <br /> : <br /> CIaimant's Signature/Date: <br /> Proof of Identification: • <br /> (photocopy of picture identification and copy of any documentation presented) <br /> EXfIIBTT C <br />