Assignment Form

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Legal Owner Information
Debtor Information



Collateral Property Information
Loan Information
Special Instructions
Storage Instructions

This is authorization to act as our agent to collect or repossess the above collateral. We agree to indemnify, and hold Reliable Recovery Services, LLC 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 claims, except, however, as such may be caused by or arise out of negligence or unauthorized acts on the part of you, your company, its officers, employees or its agents.

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