Premier Bailiffs
About Premier Bailiffs Our Services Our Staff Recovery Assignment Form Coverage Area Contact Premier Bailiffs

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 $
Insurance
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.