1: Vehicle Information

Appraised Value(Required)
Appraised Value (Verified)(Required)
Type of Tow(Required)

2: Business Information

Physical Address(Required)
Mailing Address(Required)

3: Vehicle Owner Information

(only required if vehicle owner requested tow)
Owners Address
Drop files here or
Max. file size: 20 MB.

    4: Verification and Submission

    AUTHORIZATION: I authorize Oregon Lien Source to Act on my behalf to obtain information and to give notice concerning a vehicle(s). - By checking this box, you hereby agree to the terms stated in the 'AUTHORIZATION' section above and confirm that the information provided on this form is accurate and truthful to the best of your ability. This checkbox constitutes a digital signature, and must be checked to process this Lien Service Order.