RECLAMATION FORM Identification of the applicant: Name … … … … … … … … …. Complete address: … … … … … … .. Phone number: … … … … …. Cellular: … … … … … … … ….. E-mail: …………………………………………… Details of the reclamation: Mark(brand) and year of the vehicle:et mileage … … … …. Plate number: ………………………………… Date of the towing: … … … …………………. Receipt number: …………………………………… The company possesses the other details relative to the towing: report, fax to the police services, pictures, hour and date of the towing, etc. Object of the complaint: -Refund(repayment) of cool(expenses) of towings: reasons … … … … … … … … … … … … … … … … …….. ……………………………………………………………………………………………… …………………………………… -refund(repayment) of damages caused in the vehicle: … … … ………………………………………………………. … … … … … … … … … … … … … … … … …………….. … … … … … … … … … … … … … … … … …………….. To include estimated(esteemed) with garage of damages. Know that we however inspected and photographed the vehicle with ticket machine BEFORE proceeding to the towing. So, according to the proofs which we possess, it(he) could follow from normal judicial procedures. other:……………………………………………………………………………………… ……………………………………… Please send your demand in writing in: reclamation@remorquagequebecois.com -orManagement F.S.R.Q. inc. Quebecois towing at your expenses inc. 10791, street Alfred, Montreal - North, Qc H1G 5B2