TEXAS DEPARTMENT OF LICENSING AND REGULATION

COMPLIANCE DIVISION/Tow Truck/Vehicle Storage Program

P.O. Box 12157, Austin TX 78711
Email: Towing@tdlr.texas.gov 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 Companys 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.