EmailMe Form - Clare County Wrecker Complaint Form

Clare County Wrecker Complaint Form
This form is used to file a complaint on any wrecker service within Clare County. Your Complaint will be reviewed by the Clare County Wrecker Board. Please make sure to fax all documentation to (989)539-6002 or email it to yatsk@clareco.net.

Date *

YYYY

Date of Incident *

YYYY

Location of incident *

Name *

First

Last

Address *

Street Address
Address Line 2
City	State / Province / Region
Postal / Zip Code	Country

Phone Number *

###

####

Email

Name of wrecker Service *

Address of wrecker service

Street Address
Address Line 2
City	State / Province / Region
Postal / Zip Code	Country

Please provide total amount charged and list below each item you were charged for *

Hookup

Dolly/Rollback

Fuel mileage charge

Storage

Other

Tax

Please provide a description of your complaint

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