Section- C ( Tow Trucks) Amendment Form
Please fill out the required fields and only information that has changed.
Email *
Name of wrecker service *
Name of individual filling out this application
 *
Tow Truck *
Tow Trucks- If removing, only vehicle make year and plate number is needed. (Please list the following for each new truck)
  1. Full Name
  2. Date of birth
  3. Address
  4. Phone number
  5. Years of experience
  6. Medical card Expiration
  7. Is Driver tow certified? (Only AAA, TRAA, Utah Safety Council or Wreckmaster accepted)
Truck information *
A copy of your responses will be emailed to .
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