405-789-7376
PO Box 271583 Oklahoma City, Oklahoma 73137
Oklahoma Repossessors
Home
Our Services
Assignments
Coverage Area
Your Protection
BOOK APPOINTMENT
AUTHORIZATION & HOLD HARMLESS
Assignments
Assignor Information
Assigned By
*
Company
Phone
*
Extension
Fax
Toll Free #:
Assignor's Email
*
Assignor's Email
Verify Email
Assignment Type
*
Example: Involuntary, Voluntary, Door Knock, Skip Locate, etc.
Assignment Date
Date Format: MM slash DD slash YYYY
Lien Holder / Legal Owner Information
Lien Holder / Legal Owner
*
First
Last
Owner's Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Debtor Information
Debtor's Name
*
First
Last
Home Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Employer
Work Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Home Phone
Work Phone
Date of Birth
Date Format: MM slash DD slash YYYY
Social Security #
Spouse's Name
First
Last
Spouse's Date of Birth
Date Format: MM slash DD slash YYYY
Spouse's Social Security #
Co-Maker Information
Co-Maker's Name
First
Last
Home Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Employer
Work Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Home Phone
Work Phone
Date of Birth
Date Format: MM slash DD slash YYYY
Social Security #
Spouse's Name
First
Last
Spouse's Date of Birth
Date Format: MM slash DD slash YYYY
Spouse's Social Security #
Collateral Property Information
Year
*
Make
*
Model
*
Color
License #
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
Ignition Key #
Trunk Key #
VIN #
*
Loan Information
Loan Number
*
Balance
Past Due Amount
Monthly Payment
Past Due Date
Date Format: MM slash DD slash YYYY
Special Instructions
Storage Instructions
Upload Documents
Drop files here or
This is authorization to act as our agent to collect or repossess the above collateral. We agree to indemnify, and hold Oklahoma Repossessors 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.
Copyright © 2024
Oklahoma Repossessors LLC
| All Rights Reserved.
Designed and Developed by
SMG
