SAFEClear Incident Complaint Form

SAFEClear Freeway Complaint Form
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.
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.