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The Police Impound Release Form is a crucial document in Indonesian law enforcement and vehicle administration procedures. It is required whenever a vehicle that has been impounded by the Indonesian National Police (Polri) is being released back to its rightful owner or authorized representative. This document, regulated under UU No. 22/2009 and related police regulations, serves multiple purposes: it verifies the identity of the claiming party, confirms payment of all applicable fees, documents the vehicle's condition, and provides legal protection for both the police department and the vehicle owner. The form must be completed and processed at the relevant police facility where the vehicle is held, and all supporting documentation must be verified before release is authorized.

1. Header Information: Official letterhead, form number, and date of document issuance

2. Vehicle Information: Detailed description of the impounded vehicle including make, model, year, color, license plate number, and VIN/chassis number

3. Impoundment Details: Date, location, and reason for impoundment, including reference number of impoundment record

4. Owner/Claimant Information: Full name, ID number, address, and contact details of the person claiming the vehicle

5. Release Authorization: Statement confirming authorization for release and that all requirements have been met

6. Financial Settlement: Confirmation of payment of all applicable fees and storage charges

7. Vehicle Condition: Description of vehicle condition at time of release and any noted damage or missing items

8. Release Acknowledgment: Statement acknowledging receipt of vehicle in described condition

9. Signatures: Spaces for signatures of releasing officer, claiming party, and witnesses