RECOVERY ASSIGNMENT
Witness that whereas:
Premier Bailiffs Inc. is hereby authorized and requested to seize and take possession of goods, chattels and effects as listed.
Secured Creditor
Company Name
E-Mail
Address
Contact
Fax
Phone
Postal Code
Province
City
Arrears
O/S Balance
Arrears $
Balance $
Conditional Sales Agreement
Chattel
Lease
Other
Insurance
Yes
No
Creditor Reference
Creditor File Number
Date of Contract
Length of Contract
Vehicle
Year
Vin
Make
Plate#
Model
Key Codes
Colour
Primary Debtor
Name
Address
Apt.#
City
Postal Code
Home Phone
Cell Phone
Place of Employment
Address
Phone
City
Postal Code
D.O.B
D/L #
Guarantor
Name
Address
Apt.#
City
Postal Code
Home Phone
Cell Phone
Place of Employment
Address
Phone
City
Postal Code
D.O.B
D/L #
Additional
Name
Address
Apt.#
City
Postal Code
Home Phone
Cell Phone
Place of Employment
Address
Phone
City
Postal Code
D.O.B
D/L #
Additional Comments
DIRECTION, AUTHORIZATION & INDEMNIFICATION
You are hereby appointed our agent and in so are authorized and directed to take possession of the above listed asset(s) on our behalf. We hereby agree to protect you and indemnify you against all claims for damages and costs which may be made against you by reason of your acts under this authority.
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