Online Assignments

*Lienholder:
Address:
City:
State:    Zip:
Phone:    Ext:
Fax: 
E-mail:
Collector: 

Debtor:
Address: 
City:
 State:     Zip:
Phone:
Fax:
E-mail:
SSN and Date of Birth:

Debtor's POE:
Address: 
City:
State:    Zip:
Phone:    Ext:

Co-Maker:
Address: 
City:
 State:     Zip:
Phone:
Fax:
E-mail:
SSN and Date of Birth:

Co-Maker's POE:
Address: 
City:
State:    Zip:
Phone:    Ext:

Collateral Year, Make & Model:
Plate, State & Color: 
Key Numbers:
Vehicle Identification Number: 

Loan #:
Past Due Date: 
Monthly Payment:
Loan Balance: 
Assignment Type:


Note: Should you have any information regarding family members, relatives of the debtor, or any unique or defining information that would be helpful in aiding us in the recovery of your vehicle, please enter that information in the "Instructions" space below.

Authorized by:
Date:
*All fields marked with an asterisk are required

 

National Locating & Recovery, Inc.
5553 Hwy 51
Wilsonville, Alabama 35186


PHONE: 205-678-9143
24 Hour Phone: 205-527-8305
FAX: 205-678-9142
205-678-9145


EMAIL



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