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SAFEClear Incident Complaint Form
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THIS FORM IS ONLY FOR SAFECLEAR (TOW & GO) SEGMENT SCENES ONLY! IF AN OFFICER/DEPUTY IS NOT TARGET OF COMPLAINT, DO NOT SELECT A REASON UNDER THAT SECTION.
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Please accept the following complaint form on behalf of a Driver for Car King Towing or Space City Automotive. The purpose of this form is to inform your department of an incident that has occurred on one of our Tow and Go Segments. Please review the information, images, and possibly videos, provided by the driver. If you have any questions, you may contact the driver with the contact information provided, or Jess Horton at (713)927-2632.
DRIVER INFO:
Please fill out completely. The only way this form is submitted to the appropriate person/departments is to complete all required fields.
Name
*
First
Last
Select License Type that Reflects this Complaint
*
HPD License
HCSO License
HPD or HCSO Tow and Go License #
*
Cell Phone
*
Email
*
SAFEClear Segment Incident Occurred
*
Select Segment
21 (IH45 Between North Loop & IH10)
21 (North Loop Between IH45 & IH59)
23 (IH45 Between BW8 & Airtex)
24 (BW8 Between Ella Blvd & Hardy Toll)
101 (TX249 Between Hollister Rd & Northpointe Blvd)
110 (US290 Between Hahl Rd & Mueschke Rd)
110 EXT (US290 Between Mueschke Rd & Waller County Line)
Select the Tow and Go Segment this incident occurred in.
Date and Time of Incident for this Complaint
*
Date
Time
Reason for Complaint
Pick the Best Reason for Tow Company/Driver Complaint:
*
Non-Tow & Go Wrecker on Scene
Out of Segment Tow & Go Wrecker on Scene
Unregistered/Licensed Tow Truck on Scene
Not Permitted with City Wrecker on Scene
Not Permitted with County Wrecker on Scene
Driver Soliciting at Scene
None of the Above
TEST
Pick the Best Reason for Officer/Deputy Complaint:
Officer Disregarded Tow & Go Wrecker in Segment
Officer Immediately Ask for Anything with a Hook – Segment
Officer Allowed Non-Tow & Go Drivers to Match
Officer States He/She Does Not Recognize Tow & Go
None of the Above
Attach Images of Tow Truck on Scene
*
Click or drag files to this area to upload.
You can upload up to 3 files.
Attached image of tow truck and surrounding scene.
Attach Images of Shop/Unit & Unit # on Scene
*
Click or drag files to this area to upload.
You can upload up to 3 files.
Attached images of Law Enforcement Vehicle with Unit #.
Attach Images of Tow Truck Door and TDLR
*
Click or drag files to this area to upload.
You can upload up to 3 files.
Attached image of tow truck’s door with company name/logo, and phone number, as well as photo of TDLR #, if one is on truck.
Attach Images of Tow Truck Placards/License Plate
*
Click or drag files to this area to upload.
You can upload up to 4 files.
Attached image of tow truck’s HPD and or HCSO placards, as well as license plate.
Attach Images of Driver of Tow Truck on Scene
*
Click or drag files to this area to upload.
You can upload up to 3 files.
Attached image of tow truck’s Driver on scene.
Attach Images of Officer/Deputy on Scene
*
Click or drag files to this area to upload.
You can upload up to 3 files.
Attached image of Officer/Deputy on scene.
Attach Images of Vehicle Loaded by Tow Truck on Scene
*
Click or drag files to this area to upload.
You can upload up to 4 files.
Attached image of vehicle loaded by tow truck on scene, as well as vehicle license plate and VIN.
Attach Video of Truck/Driver/Vehicle Loaded At Scene
Click or drag files to this area to upload.
You can upload up to 4 files.
Attach videos of tow truck, driver of tow truck, and vehicle loaded at scene with all the info requested in pictures.
Attach Video of Officer at Scene
Click or drag files to this area to upload.
You can upload up to 4 files.
Attach videos of Officer/Deputy at scene with all the info requested in pictures.
Reason for Complaint
*
Give a brief description of the complaint.
Describe the Complaint – Detailed
*
Give a clean, but detailed description of the action or issue that is the reason for this complaint. Be frank and not to drawn out. MUST BE A LEGITIMATE COMPLAINT REASON.
Pick Which Department(s) Best Fit Jurisdiction For Complaint
*
HPD Only
HPD W/ County Tow Tag Only Complaint
HPD W/ HCSO District Deputy Complaint
HPD W/ Pct 1 Constable Complaint
HPD W/ Pct 2 Constable Complaint
HPD W/ Pct 3 Constable Complaint
HPD W/ Pct 4 Constable Complaint
HPD W/ Pct 5 Constable Complaint
HPD W/ Pct 6 Constable Complaint
HPD W/ Pct 7 Constable Complaint
HPD W/ Pct 8 Constable Complaint
HPD W/ MAP Unit Complaint
HPD W/ Other Jurisdiction (Non HCSO or Constable) Complaint
HCSO Only (District Unit)
HCSO W/ HPD Officer Complaint
HCSO W/ City Tow Tag Only Complaint
HCSO W/ Pct 1 Constable Complaint
HCSO W/ Pct 2 Constable Complaint
HCSO W/ Pct 3 Constable Complaint
HCSO W/ Pct 4 Constable Complaint
HCSO W/ Pct 5 Constable Complaint
HCSO W/ Pct 6 Constable Complaint
HCSO W/ Pct 7 Constable Complaint
HCSO W/ Pct 8 Constable Complaint
HCSO W/ JVPD Complaint
HCSO W/ MAP Unit Complaint
HCSO W/ Other Jurisdiction (Non HPD) Complaint
TEST
Pick the Correct Department(s), or this will go to the wrong persons!
Submit