PETITION

1. The petitioner requests a court hearing to determine
 
 

 a. whether a vehicle owned by the petitioner was properly deemed abandoned or removed according to law.
 b. the reasonableness of towing/storage fees.

 .
 a. The accrued towing and storage fees were paid directly to the vehicle custodian, and a $40.00 fee was paid to 

 

 b. Bond in the amount of the accrued towing and storage fees and a $40.00 fee were paid to the court.

2. The accrued towing and storage fees are $ 
 
 
 

        the court.

3. The vehicle is described as follows:

Year

Make

Model

VIN

License plate no.

4. The vehicle described above was removed on 

5. The petitioner received notice of the removal on 

Date

Date

Police agency/Private property owner

 . 

 by 

 .

6. For purposes of providing notice of hearing, the applicable names and addresses are provided below:

 

Owner

Secured Party

Police Agency

Vehicle Custodian

Towing Agency

Private Property Owner

Name

Name

Name

Name

Name

Name

 

Date

Approved, SCAO
Form DC 90, Rev. 11/19
MCL 257.252a, MCL 257.252f
Page 1 of 2

Address

Address

Address

Address

Address

Address

Petitioner

Distribute form to: 
Court 
Petitioner
Respondent 
Vehicle custodian

STATE OF MICHIGANJUDICIAL DISTRICTPETITION REGARDING IMPOUNDMENT OF MOTOR VEHICLECASE NO. and JUDGECourt address                     Court telephone no.     Petitioner’s name, address, and telephone no.vRespondent’s name, address, and telephone no.Note: The petitioner must be an owner or secured party of the vehicle.Note: The respondent may be a police agency, towing agency, vehicle custodian, or private property owner. Petition Regarding Impoundment of Motor Vehicle 
Page 2 of 2

(11/19) 

Case No. 
 

For court use only

NOTICE OF HEARING

A hearing on the above petition will be held on 

Date and time

Persons with knowledge of the facts should appear at this hearing. 

at 

Location

 

                     

Judge/Deputy clerk signature and date

 
 

 .

If you require accommodations to use the court because of a disability or if you require a foreign language interpreter to help 
you fully participate in court proceedings, please contact the court immediately to make arrangements.

CERTIFICATE OF MAILING

I certify that on this date I served a copy of this petition and notice on the parties and any other person required to receive 
notice  by  first-class  mail  addressed  to  their  last-known  addresses  as  defined  by  MCR  2.107(C)(3).  I  declare  under  the 
penalties of perjury that this certificate has been examined by me and that its contents are true to the best of my information, 
knowledge, and belief.

 

                     

Deputy clerk signature and date