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. F& M T - - - <br /> & Auto Saly r , t - <br /> S r~n3001 Main Street IIIC• ~ - <br /> - Phone (54 i( j~9~+eid, Oregon 97478. W I - <br /> 5615. ~ - s <br /> T <br /> 24-HOUR o!i Free i$pQ386-56 i5 . <br /> - TOWING ~ <br /> ~ <br /> MAKE ~ DATE _ ' <br /> 80rlYTYPE YEAR } - <br /> STATE G'1.. ~ n <br /> - FOWEp DESCRIPTIONOFCH,4~E REG. NO. <br /> WED ~ ~ , / L' t , ~ S AMOUNT ~ ~ V ~ ~ ~ S ~ f <br /> STORAGE <br /> ~W I 3~ <br /> TD <br /> _uSEES <br /> puTStp <br /> BoR ~ <br /> <br /> I, &ICOVERY ~ <br /> AUTHO~D-~~ - 4 <br /> 7hc undersigned ~ - ~l <br /> fo <br /> bhclnc. within th~ <br /> y <br /> X30) dayx from d roll <br /> ~ crv <br /> y F M Towing & Auto Sal. _ . - . 1 <br /> ~crvic~dcxctjb~a~c. Intctceit T~AL ~ L/t <br /> nitatlatxobepaid. Thc tltcratco ~m0°nt~fonhabovc CHARGES ~ G_ <br /> ;attomcysora ~~^i8ncdfunhma. pcrannumfmmdatc 1 i.~ ® \ <br /> Sent forcolkp;~ u bmc amt understand that F 1 U <br /> ItaYmcnt service Pon the capitation bf. & M T ^n'~ <br /> °rf+anofcucha~eofSS.Op,~usa tiaid3pda °wing&Auto .1 ®h~/ <br /> SIGtV ~ •plusattotnM,.v~~'Dnipkattorney,yf~lo~ <br /> k thatevrntthcundcnalvagc.lnc.mayfotward ' <br /> ED ~'vir Mb gncd. 'oirtd this account ro rh I <br /> BY x atcd by appeals from a ~yh <br /> ~ bwcr coin ~xtron lz nuituBCd to colkc~thc wholcr <br /> ADDRE~ ` ~ ~O <br /> chap nq ~ s~ agree. Mat F & M T <br /> owin <br /> held liable for dam <br /> oreyuipmrnt, occunin aSc b the above mo Salvage. Inc. <br /> theposition,l 8duringdM dcticribedvgtic ~ ` . <br /> _ remov <br /> I <br /> oca ' al c 1 <br /> n N <br /> on ort S <br /> q or tans UR <br /> fl°m~YlocatioY ature~ <br /> chfh ~h~ <br /> hcyMhcundengncdfn~ott~r.. S1GNgTURENAME _ - <br /> Mtb/icorprivatc. mnovalofthevchiclc <br /> INSURANCE CD . <br /> X--~~` ~ ' <br /> Poucr~ <br /> hove au <br /> IFtor)zed F $ M TOWIN AGENT~e . <br /> hereby authorized my Insurance ~ AUTO SALVgGE INC- to tow m <br /> Y behalf. Pant ~ moke PaYt+tent Y cor <br /> Bnolure uk and <br /> 1E" <br /> rt~`~ ,c... 'L^amt ?o this towing ~e~y on <br /> ~ ` G Q/"` Dote ' <br /> LESS ~ ~ "t-••~.,,,.,,,s~ . <br /> ___..._.--r-- • . - <br /> <br />