AUTHORIZATION TO REPOSSESS
&
HOLD HARMLESS AGREEMENT

R-9400010

ASSIGNED TO: EBY INVESTIGATIVE LEGAL SERVICE & RECOVERY OF SARASOTA,  INC.
ADDRESS: P.O. BOX 2053, ENGLEWOOD, FL 34295
PHONE: 941-475-7705        FAX: 941-475-7901        e-mail ebyils@ewol.com

DATE:            ACCOUNT #

CLIENT: 

ADDRESS:

ASSIGNED BY:

PHONE:             FAX:

 
DEBTOR:

ADDRESS:

CO-DEBTOR:

ADDRESS:

PERTINENT INFORMATION (EMPLOYMENT, PHONE, SS#, RELATIVES, ETC.)

YEAR:     MAKE:    MODEL:

VIN:   TAG:   STATE:

COLOR:   KEY CODE:  DOOR: ING:

 
PAST DUE FOR: $  DATE OF LAST PMT:

PAST DUE DATE:      LAST PMT:$

MONTHLY $   LOAN BALANCE:

DATE OF LAST CONTACT:

 
THE ABOVE IS YOUR AUTHORIZATION TO ACT AS OUR AGENT TO COLLECT OR REPOSSESS THE ABOVE COLLATERAL.  WE AGREE TO INDEMNIFY AND HOLD YOU HARMLESS FROM AND AGAINST ANY AND ALL CLAIMS, DAMAGES. LOSSES AND ACTIONS, INCLUDING REASONABLE ATTORNEY FEES, RESULTING FROM AND ARISING OUT OF YOUR EFFORTS TO COLLECT AND OR REPOSSESS THE ABOVE LISTED ASSIGNMENTS.  EXCEPT SUCH AS MAY BE CAUSED BY OR ARISE OUT OF NEGLIGENCE OR THE PART OF YOU, YOUR COMPANY, ITS OFFICERS, EMPLOYEES OR ITS AGENTS.

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