Southwest Recovery, Inc. Florida Repossessions

Toll-Free Ph: 800-775-7376
Phone: 941-766-1300
Fax: 941-766-1312

Lic R 2300006

Online Assignments

*Lienholder:

Address:

City:

State:

Zip:

Phone:

Ext:

Fax:

E-mail:

Collector:

Debtor:

Address:

City:

State:

Zip:

Phone:

Fax:

E-mail:

SSN and Date of Birth:

Debtor's POE:

Address:

City:

State:

Zip:

Phone:

Ext:

Co-Maker:

Address:

City:

State:

Zip:

Phone:

Fax:

E-mail:

SSN and Date of Birth:

Co-Maker's POE:

Address:

City:

State:

Zip:

Phone:

Ext:

Collateral Year, Make & Model:

Plate, State & Color:

Key Numbers:

Vehicle Identification Number:

Loan #:

Past Due Date:

Monthly Payment:

Loan Balance:

Assignment Type:

Note: Should you have any information regarding family members, relatives of the debtor, or any unique or defining information that would be helpful in aiding us in the recovery of your vehicle, please enter that information in the "Instructions" space below.

Please provide information and instructions in this space:

This is your authorization to act as our agents to collect or repossesses, on sight, the below collateral which is covered by default instrument. We agree to indemnify and save your harmless from and against any and all claims except unauthorized acts of your firm. You will not be held liable for the mechanical operation of the vehicle or for insurance protection except in case of neglect. This indemnification is granted as consideration for your acting as our agent. It is agreed that the laws of your state shall be applicable. Client agrees to Southwest Recovery Inc.'s fees. Your immediate efforts will be appreciated.

Authorized by:
Date:
*All fields marked with an asterisk are required