EOEEA-DPU

Company Name:(Required)

Name(Required)

First Last

Company Owner:(Required)

DPU Certificate Number:(Required)

Business Office Address:(Required)

Street Address Address Line 2 City State ZIP Code

Mailing Address (if different than business address):

Street Address Address Line 2 City State ZIP Code

Email Address(Required)

Storage

1. Location of Storage Yard (If different than business address)

Street Address Address Line 2 City State ZIP Code

2. Location of Storage Yard (If different than business address)

Street Address Address Line 2 City State ZIP Code

We Have Indoor Storage Available:(Required)

Yes

No

Daily Charge for Indoor Storage, if Applicable:

Income From Towing

Number of Police Ordered Tows Performed in 2024:(Required)

Total Revenue From Police Ordered Tows Performed in 2024:(Required)

Number of Trespass Tows Performed in 2024:(Required)

Total Revenue From Trespass Tows Performed in 2024:(Required)

Incomplete Tows/ “Dropped Vehicle” Before Tow Was Completed

Number of Tows:(Required)

Total Revenue:(Required)

Total Revenue From Vehicle Storage in 2024

Number of Tows:(Required)

Total Revenue:(Required)

Fees

If you charge the following fees, please enter the fee or average fee into the field. If you do not charge this fee, enter “0”.

Gate Fee:(Required)

Administrative Fee:(Required)

After Hours Vehicle Release Fee:(Required)

Add additional fees not listed.

1. Name of fee:

Enter amount

2. Name of fee:

Enter amount:

3. Name of fee:

Enter amount:

If you charge an After Hours Vehicle Release Fee, please enter the Days or Times that are “After Hours”:(Required)

Municipal Fees

Please enter the names of the cities and towns where you perform involuntary towing (both police ordered or trespass tows)

1. City or Town:

Municipal Fee Charged to You: (please specify if the charge is annual or per tow)

Municipal Fee -If You Collect the Fee From the Motor Vehicle Owner: (enter dollar amount collected per tow)

2. City or Town:

Municipal Fee Charged to You: (please specify if the charge is annual or per tow)

Municipal Fee -If You Collect the Fee From the Motor Vehicle Owner: (enter dollar amount collected per tow)

3. City or Town:

Municipal Fee Charged to You: (please specify if the charge is annual or per tow)

Municipal Fee -If You Collect the Fee From the Motor Vehicle Owner: (enter dollar amount collected per tow)

4. City or Town:

Municipal Fee Charged to You: (please specify if the charge is annual or per tow)

Municipal Fee -If You Collect the Fee From the Motor Vehicle Owner: (enter dollar amount collected per tow)

5. City or Town:

Municipal Fee Charged to You: (please specify if the charge is annual or per tow)

Municipal Fee -If You Collect the Fee From the Motor Vehicle Owner: (enter dollar amount collected per tow)

6. City or Town:

Municipal Fee Charged to You: (please specify if the charge is annual or per tow)

Municipal Fee -If You Collect the Fee From the Motor Vehicle Owner: (enter dollar amount collected per tow)

7. City or Town:

Municipal Fee Charged to You: (please specify if the charge is annual or per tow)

Municipal Fee -If You Collect the Fee From the Motor Vehicle Owner: (enter dollar amount collected per tow)

8. City or Town:

Municipal Fee Charged to You: (please specify if the charge is annual or per tow)

Municipal Fee -If You Collect the Fee From the Motor Vehicle Owner: (enter dollar amount collected per tow)

9. City or Town:

Municipal Fee Charged to You: (please specify if the charge is annual or per tow)

Municipal Fee -If You Collect the Fee From the Motor Vehicle Owner: (enter dollar amount collected per tow)

Is there addition information or clarification that you want to provide for this annual financial statement: