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Submit an Assignment

American Finance Adjusters
Seven Offices Throughout Florida to Serve You 24 Hours, 7 Days a Week
Services Available anywhere In North & South America, Mexico and the Caribbean

Toll Free Assignment Center: 1.800.633.8455
Fax : 1.352.351.4515


to collect or repossess the above collateral. We agree to indemnify and hold you 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. Click to go back to the AFA web site">

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Lienholder:

Address:

City: State: Zip:

Phone: Extension: Fax:

E-mail:

Collector:

Debtor:

Address:

City: State: Zip:

Phone: Extension: Fax:

E-mail:

Social Security Number and Date of Birth:

Employment:

Address:

City: State: Zip:

Phone: Extension: Fax:

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.

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 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.

Authorized by:Date:

Please type in the box the numbers and/or letters you see.
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Any questions? Please contact us at 1.800.633.8455. You may also contact us via email at:

bigr@atlantic.net

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