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TYPE OF REPOSSESSION
Involuntary
Voluntary
FULL ADDRESS

DEBTOR INFORMATION

SPOUSE'S INFORMATION

Vehicle Information

Additional Information

Working Key On File
Equipped with GPS

IF YES, PLEASE PROVIDE LOG IN INFORMATION

This serves as your authorization to proceed with the collection or repossession of the above-described assignment. We agree to indemnify and hold you harmless from all claims, damages, losses, and actions resulting from or arising out of our efforts to collect or repossess the above-referenced property, except for those caused by the acts or omissions of your officers, employees, or the officers or employees of any authorized agents.

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