Lender’s Recourse Inc. - Online Assignent Form

Assignments

To submit an online assignment, fill out and submit the form below with the required information. Upon submittal you an electronic receipt and copy of the transaction including the date of transmission will be sent to the e-mail address provided.
Field names in RED are required fields.

ASSIGNMENT OF CLAIM AS PROVIDED IN UNIFORM COMMERCIAL CODE 9.503: Unless otherwise agreed a secured party has on default the right to take possession of the collateral. In taking possession a secured party may proceed without judicial process if this can be done without breach of the peace or may proceed by action. If the security agreement so provides the secured party may require the debtor to assemble the collateral and make it available to the secured part at a place to be designated by the secured party which is reasonably convenient to both parties. Without removal a secured party may render equipment unusable, and may dispose of collateral on the debtor's premises under Section 9.504

A/C No:

Date:

Legal Owner:

Attn:

Address:

City:

State:

Zip:

Phone:

Fax:

E-mail:

Debtor:

Address:

City:

State:

Zip:

SS#:

DOB:

Phone:

Employer:

Employer Phone:

Employer Address:

Employer City:

Employer State:

Employer Zip:

Additional Information:

Year:	Make:	Body Style:
Color:	License:	State:
VIN:
Identifying Data:

Past Due:

Payments:

Balance:

Client Instructions:

This is your authorization to act as our agents to collect or repossess the above collateral.

We agree to indemnity 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 claims, except however such as may be caused by or arise our of negligence or unauthorized act or the part of you, your company, its officers, employees or its agents.

Authorized By:

Date: