San Antonio
Repossession
Agency
1303 Rilling Rd, San Antonio,TX 78214
LENDER INFORMATION
This 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 claim. damages, losses, and actions including reasonable attorney 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.
LENDER
PHONE
ADDRESS
STREET ADDRESS
CITY
STATE/PROVINCE/REGION
EMAIL
COLLECTOR
DEBTOR
DEBTOR'S ADDRESS
STREET ADRRESS
ADDRESS LINE 2
CITY
STATE/PROVINCE/REGION
POSTAL / ZIP CODE
POSTAL / ZIP CODE
DEBTOR'S PHONE
EMPLOYMENT INFORMATION
EMPLOYMENT
EMPLOYMENT ADDRESS
STREET ADDRESS
CITY
STATE / PROVINCE/ REGION
POSTAL / ZIP CODE
PHONE NUMBER
LOAN INFORMATION
DEBTOR'S INFORMATION
YEAR
MAKE
MODEL
COLOR
LICENSE PLATE
KEY CODE
LOAN ACCOUNT
COLLATERAL INFORMATION
VIN
PAST DUE DATE
MONTHLY PAYMENT
LOAN BALANCE
ASSIGNMENT TYPE*
COMMENTS/MISC. INFORMATION
STORAGE INSTRUCTIONS
AUTHORIZED BY*
DATE TIME
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