Tri State Recovery

New England’s Trusted Recovery Partner. Proudly Serving Massachusetts, Rhode Island, & New Hampshire Since 1994
New England’s Trusted Recovery Partner
Proudly Serving Massachusetts, Rhode Island, & New Hampshire Since 1994
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AUTHORIZATION & HOLD HARMLESS

Assignments

"*" indicates required fields

This field is for validation purposes and should be left unchanged.

Assignor Information

Assignor's Email
MM slash DD slash YYYY

Example: Involuntary, Voluntary, Door Knock, Skip Locate, etc.

Lien Holder / Legal Owner Information

Lien Holder / Legal Owner
Owner's Address*

Debtor Information

Debtor's Name*
Home Address*
Work Address
MM slash DD slash YYYY
Spouse's Name
MM slash DD slash YYYY

Co-Maker Information

Co-Maker's Name
Home Address
Work Address
MM slash DD slash YYYY
Spouse's Name
MM slash DD slash YYYY

Collateral Property Information

Loan Information

MM slash DD slash YYYY
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    This is authorization to act as our agent to collect or repossess the above collateral. We agree to indemnify, and hold Tri State Recovery 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.