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� ' ' , ' �RAIRIELAND TOWING, INC. CITIZEN TOWING CRITIQUE FORM <br /> 2902 NORTH WOODFORD ST. CITY OF DECATUR-AUTHORIZED <br /> DECATUR,ILLINOIS 62526 TOWS <br /> Complete this form listing dates, times and complete witness information. Deliver the <br /> completed and signed form to a representative of the towing company, and you will receive a copy <br /> for your records. <br /> CUSTOMER NAME: <br /> CUSTOMER ADDRESS: <br /> CUSTOMER PHONE: <br /> DATE FILED: TIME: <br /> DATE OF TOW: CHARGES: <br /> LOCATION OF TOW: <br /> STATEMENT �I'� <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 /> EXHIBIT B <br />