ma MODEL BODY 5mg no. I
1995 CADILLAC 4 DOOR 14323694742 .


DEPARTMENT OF ADMINISTRATIVE 
MUNICIPAL HEARING DIVISION
VEHICLE MOUNDMENT

REQUEST FOR on Tow and Storage Fees

MCC 2-14-1245

I I All awner of record who files a timely Request for Hearing form will be notified of the hearing  and 
tln'le In person or by mail. If the vehicle remains impounded al the time a is amend. slaw:
to accumulate until the vehicle IS redeemed.

  
 

If the owner of record requests a hearing bu| fails to appear at Ihe healing, fails to request a heaenyn
timely manner, the awner of record shall be deemed In have waived his or her rights to a hearing and a (Mad

finding of shall be entered 
My vehicle has I has no! A, released from the 1qu pound (check app/Lucy nsponsek

Reason for Impoundment: instigation hold, uremia-related (enamel--Ml
Inventory No.1 2  Dakeol'lmpoundment: 5' 

Owner of Record
Name:
Address:
City:
Phone 

Vehicle dentifica 'on
VJ.le gfiggzp 763 LicJ'lleN; 65' 7--523
Make: ng LL64 Body S'lyle10 

Pursuant In Section 244435 oflhe Municile Code ofChicagp, I hueby a
towing and sewage fees of the above identified vehicle. 

 
   

 

 

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PURSUANT TO YOUR REQUEST FOR HEARING. YOU HAVE SCHEDULED APPEAR AT:

400 W. Slips-Ear, Roomllo, lenl Healing Facility, adage. 11.. On:
I

W) (fill)

 

5:4"

   
  

CERTIFICATION OF SERVICE