Secure Storage Program

Vehicle Location - Current *
Vehicle Location - Current
Crash Date *
Crash Date
Verified by the Search Tool, Bosch software, or our Service Team.
Phone
Phone
I am the owner or lessee, or am now the appointed administrator, or personal representative of the estate, or legal representative of such an owner, or a law enforcement officer with the appropriate documentation, of the described vehicle that may have stored electronic data on the said vehicle’s components. I acknowledge my rights under the "Driver Privacy Act of 2015," and I am hereby authorizing Black Box Recovery to recover and/or store the components from the said vehicle.
Authorization Signature *
Authorization Signature
Submit YOUR electronic signature.
Verification Signature *
Verification Signature
Verify YOUR electronic signature.
If Title not listed please describe.
Select # of month/s to store Black Box (+ $50/Mo.)
Enter Your Affiliate Code

Thank You for submitting this form online.