Repossessions Unlimited LLC    

                                                                        Servicing  Florida
                  561-257-0800 Office / 561-257-0801 Fax                       

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Assignments


A
Assignment Form


     Repossessions Unlimited, LLC
  
    Office: 561-257-0800
  Fax: 561-257-0801
R2500048
     


            ********** PLEASE FILL OUT ALL AREAS OF THIS FORM**********

 LIEN HOLDER INFORMATION
Lien Holder:
Address:
Address Street 1:
Address Street 2:
City:
Zip Code: (5 digits)
State:
Daytime Phone:
 Ext:  
Fax:
Email:
Collector:

 
 ---------------------------- ---------------------------------------------------------------------------------
   
  COLLATERAL INFORMATION

 Vehicle Identification Number (VIN):  
 Year, Make, Model:  
 Plate and Color:  
 Plate State:  
 Key Code:  
   
 ----------------------------  ---------------------------------------------------------------------------------
   
  DEBTOR INFORMATION

Debtor:
Home Address:
LIS Address:
City:
State:
Phone:
 Social Security / Date of Birth:  
   
 ---------------------------- -----------------------------------------------------------------------------------
   
 
EMPLOYMENT INFORMATION

 Employer:  
 Address:  
 City:  
 State:  
 Phone:  
 Ext:  
   
 ---------------------------- -----------------------------------------------------------------------------------
   
  LOAN INFORMATION

 Loan/Account Number:  
Past Due Date:
 Past Due Amount:  
 Monthly Payment:  
Loan Balance:
   
 ---------------------------- -----------------------------------------------------------------------------------
   
   ASSIGNMENT TYPE
  Note:   (Only Check One Service Type)
   Involuntary
   Voluntary
   Impound
   Field Visit
   Condition Report and Pictures
   
   *******Please provide any comments in the section below towards debtors relatives, past interaction with debtor, skip work, cease and desist instructions and anything special for this unit and/or debtor that would help in the recovery of the unit******
Comments:
   
 
 This is your (Lien Holder) authorization to act as our agent to collect or repossess the above collateral. We (Lien Holder) agree to indemnify and hold harmless Repossessions Unlimited, LLC and its employees, officers and agents from and against any and all claims, damages, losses and actions including reasonable attorney fees resulting from and/or arising out of Repossessions Unlimited, LLC efforts to repossess and/or collect the above described collateral. Except, however, as such may be caused by and/or arise out of negligence or unauthorized acts on the part of Repossessions Unlimited, LLC, its employees, officers and agents.
 Authorized Agent :  
 Date:  

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