The Form 4669 is an essential document used in Missouri to report abandoned property, specifically vehicles that have been towed from private property. This form must be completed by the owner, lessee, or property manager, and it serves as a legal declaration that outlines the circumstances surrounding the tow. Understanding how to properly fill out this form is crucial for ensuring compliance with state regulations and protecting your rights.
If you need to fill out the Form 4669, click the button below for assistance.
The 4669 Missouri form, officially known as the Abandoned Property Report, serves a crucial function in the management of abandoned vehicles on private property. This form is primarily designed for property owners, lessees, or security managers who need to document the towing of vehicles that have been left unattended on their premises. The completion of this form involves multiple sections, each requiring specific information from different parties involved in the towing process. For instance, Section A must be filled out by the property owner or manager, while Section B is designated for the towing company, and Section C is reserved for law enforcement agencies. The form allows the property owner to authorize the towing of a vehicle based on specific criteria, such as the presence of a no-parking sign or the duration the vehicle has been abandoned. Additionally, it includes vital details such as the vehicle’s make, model, and identification number, as well as the notification timeline for law enforcement. Timely submission of the form is essential, as it must be provided to the relevant law enforcement agency within specified time frames, depending on the reason for the tow. This structured approach not only ensures compliance with state regulations but also protects the rights of all parties involved.
Form
4669
Abandoned Property Report
Owner, Lessee, Property
Must Complete
A — Private Property
or Security Manager
Section
Section B — Towing Company Must Complete
— Law Enforcement Agency
Section C
I authorize the vehicle to be towed based on the reason indicated below. Select a reason:
r 1. A sign not less than 17 x 22 inches in size containing lettering not less than one inch in height is displayed within plain view prohibiting public parking. I will notify the law enforcement agency within one hour of the tow.
r2. The abandoned property was left unattended on owner-occupied residential property with four units or less. I have notified the
__________________________________________ law enforcement agency and ten hours have elapsed since that notification.
r3. The abandoned property was left unattended on private property. I have notified the _________________________________
law enforcement agency and ninety-six hours have elapsed since that notification.
I certify that the vehicle listed below was abandoned on property of which I am the owner, lessee, or property or security manager. This form is for tows from private property not authorized by law enforcement. I have authorized the towing company listed below to remove the vehicle from my property and witnessed the removal of the vehicle. I further certify that all information contained herein is true and accurate to the best of my knowledge. I understand this is a legal declaration subject to criminal penalties.
Signature of Owner, Lessee, Property or Security Manager
Phone Number of Owner, Lessee, Property
or Security Manager (___ ___ ___) ___ ___ ___ - ___ ___ ___ ___
Printed Name of Owner, Lessee, or Property Security Manager
Date of Tow (MM/DD/YYYY)
___ ___ / ___ ___ / ___ ___ ___ ___
Location of Abandoned Property to be Towed (Street Address, City, State, and Zip Code)
Name and Address of the Abandoned Property or Driver Owner, If Known
Name and Address of the Lienholder of the Abandoned Property, If Known
Description of Damage to the Abandoned Property
Year
Make
Model
Vehicle Identification Number
Mileage
Plate Number
State
Storage Location of the Abandoned Property
Law Enforcement Agency Notified (Must be Same Agency in Section A)
Date Notified (MM/DD/YYYY)
Time Notified
Law Enforcement Agency Address
City
Law Enforcement Agency Phone Number
(___ ___ ___) ___ ___ ___ - ___ ___ ___ ___
Name of Towing Company
Tower Has Online Access
Towing Company Phone Number
to DOR Records
r Yes
r No
Address of Towing Company
Zip Code
Note: This report must be given to the law enforcement agency shown above within two hours of the tow if reason 1 is checked above or within twenty-four hours for all other tows.
Signature of Towing Operator
Printed Name of Towing Operator
Must be Completed by Law Enforcement Agency under Section 304.157, RSMo.
Law Enforcement Agency
Date Notified of Tow (MM/DD/YYYY)
Date Report Filed (MM/DD/YYYY)
Inquiry Date (MM/DD/YYYY)
r
NCIC (Provide Number) ___________________
MULES
REJIS
Other
MSHP Number
Report, Case, Incident, Tow Number
Abandoned Property Owner’s Name
Address
Lienholder’s Name
Signature of Officer
Printed Name of Officer
Badge
Form 4669 (Revised 08-2022)
Abandoned Property Report Instructions
•Owner, lessee, property, or security manager completes and signs this form;
•Towing company completes, signs, and delivers this report to the law enforcement agency within two hours of the tow if reason one is checked on front or within twenty-four hours for all other tows;
•Law enforcement officer completes and signs this form and retains a copy for their files;
•Towing company sends the original Form 4669 to the Missouri Department of Revenue (Department) if property remains unclaimed after ten days and the tow company does not have online access to Department records;
•Towing company retains their copy of the Form 4669 for three years;
•Towing company must notify the Department in writing of any address change;
•Towing companies with online record access must check Department records online for owner and lienholder information;
•If the towing company does not find owner or lienholder information using the online record check, the towing company, within ten days of the tow, must send a copy of the completed “No Record” screen from the online record search and the Form 4669 to the address below for further research.
Motor Vehicle Bureau, Record Center PO Box 2048
Jefferson City MO 65105-2048
•The Department will perform a record search for the name and address of the owner and lienholder of record within five working days of receipt of the Form 4669 submitted by tow company (no online access) or a completed “No Record” screen from the online record search and the Form 4669 submitted by the towing company (with online access). A Department search will be done by:
1)Searching the Department files; or
2)Initiating an inquiry with another state if the evidence presented indicates the abandoned property was registered or titled in another state.
•The Department will send a notification letter to the towing company within 15 working days after the search is completed with the following information:
1)The name and address of the owner and lienholder; or
2)Instructions if there is no record information available (please see below).
•Towing company must send a completed Vehicle Owner and Lienholder Notification (Form 4577) by certified mail, return receipt requested within ten days to the owner or lienholder as provided from the Department records.
No Information Found on
Record Notification Received
Apply for Original, Salvage, or
Abandoned Property Titles
How to
Junk
If the Department has no record of the abandoned property, the towing company must certify that a physical search of the abandoned property disclosed no other evidence of ownership. The towing company must also certify that a good faith effort was made to establish the prior state of registration and title by checking the items below:
1)The abandoned property for any type of license plates, license plate record, temporary permit, inspection sticker, decal, or other evidence that may indicate a state of possible registration and title;
2)The tow ticket or report of the tow operator to see if a license plate was on the abandoned property at the beginning of the tow, if a private tow; and
3)The tow ticket or report of the tow operator to see if any information is indicated for the Driver, Owner, or Lienholder of the vehicle.
Note: The Department will provide the tower with a notification letter to certify the above checks have been made. This certification must accompany the application for title.
Send all title applications on abandoned property to the address below.
Submit the following when applying for a title for an abandoned vehicle:
1)Application for title with appropriate fees, properly completed in the towing company’s name. The title type must be marked “Original”, “Salvage”, or “Junking Certificate” (Tow company not required to pay title fee, or sales tax.);
2)Abandoned Property Affidavit (Form 4576) properly completed, signed by the tower, and notarized by a notary public;
3)A copy of the Vehicle Owner and Lienholder Notification (Form 4577) issued to any owner and lienholder of record. This must be sent by certified mail;
4)A copy of the certified mail return receipt(s) at least 30 days old, indicating all owners and lienholders of record, if applicable, have been sent Form 4577 (see 3 above);
5)A copy of the notification the Department of Revenue issued to the towing company or a copy of the “Record Lookup Results” screen from the online record search;
6)A completed and signed Vehicle Examination Certificate (Form 551), if applying for an “Original” title (contact the nearest Highway Patrol Headquarters for vehicle inspection); and
7)Abandoned Property Report (Form 4669) completed by owner, lessee, property or security manager, tow company, and local law enforcement agency.
Important: Mileage must be shown on the application for title for vehicles model year 2011 and newer until the vehicle reaches the age of twenty years old. If the mileage is unobtainable, write in an estimated mileage and a statement at the bottom of the application that mileage is only estimated. Complete and attach an odometer disclosure statement (Form 3019) and include the reason for mileage estimate: fire, digital dash inoperable, or other. This must accompany the application for title.
Mail to: Motor Vehicle Bureau P.O. Box 2048
Jefferson City, MO 65105-2048
Phone: (573) 526-3669
Visit dor.mo.gov/motor-vehicle/titling-abandoned-property/
for additional information.
Ever served on active duty in the United States Armed Forces?
If yes, visit dor.mo.gov/military/ to see the services and benefits we offer to all eligible military individuals. A list of all state agency resources and benefits can be found at veteranbenefits.mo.gov/state-benefits/.
Mo-1nr - The Missouri Form MO-1NR is used for income tax payments by nonresident individual partners or S corporation shareholders.
For individuals looking to simplify their estate management, the Small Estate Affidavit process provides an efficient method for resolving the affairs of smaller estates. By utilizing this form, one can navigate the complexities of distributing assets with minimal hassle.
Missouri Car Sales Tax Loophole 2022 - Clarifies the eligibility and documentation required for obtaining a sales tax exemption.
Missouri Sales Tax Filing Frequency - The form allows for authorization by the Department of Revenue to issue potential refunds to the vendor.