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AUTHORIZATION
TO REPOSSESS & HOLD HARMLESS AGREEMENT
ASSIGNED TO:
EBY INVESTIGATIVE LEGAL SERVICE & RECOVERY, INC.
P.O. BOX 2053, ENGLEWOOD, FL 34295
PH: (941) 475-7705 FAX:
(941) 475-7901
brian@ebyils.com R-9400010
You
can fill in the information below to email your Hold Harmless Agreement
----- OR -----
CLICK HERE to print a Hold Harmless Agreement and fax to
941-475-7901
(NOTE: We will need a
copy of the title either way.)
DATE:
ACCOUNT #
CLIENT:
ADDRESS:
ASSIGNED BY:
PHONE:
FAX:
EMAIL:
LIEN HOLDER:
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DEBTOR:
ADDRESS:
DOB:
SS#:
PHONE:
POE:
POE ADDRESS:
POE PHONE:
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CO-DEBTOR:
ADDRESS:
DOB:
SS#:
PHONE:
POE:
POE ADDRESS:
POE PHONE:
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PERTINENT INFORMATION (EMPLOYMENT, PHONE,
SS#, RELATIVES, ETC.)
YEAR:
MAKE: MODEL:
VIN:
TAG:
STATE:
COLOR:
PAST DUE FOR: $
DATE OF LAST PMT:
PAST DUE DATE:
LAST PMT:$
MONTHLY $
LOAN BALANCE: $
DATE OF LAST CONTACT:
OTHER INFORMATION:
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| This is your
authorization to act as our agent to collect or repossess the listed
collateral. We agree to indemnify and hold you, your company, its
officers, employees and its agents harmless from 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 collateral except such as may be caused by or arise
out of negligence on the part of you, your company, its officers,
employees and its agents. |
AUTHORIZED BY:
DATE:
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Attach Supporting Files to upload (Title, etc.)
( If you have more than 2 attachments please
attach to an email to
brian@ebyils.com
)
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CLICK
TO SEND REQUEST BY EMAIL
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