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REPOSSESSION ORDER FORM - PRINT AND FAX TO (305) 397-1592

CLIENT INFORMATION

Client Name:
Address:
City, State, Zip Code:
Phone:
Cell Phone::
E-Mail:
Fax:
DEPTOR INFORMATION (PERSON IN POSSESSION OF PROPERTY)
Deptor name:
Address:
City, State, Zip Code::
Phone:
Date of Birth:
SS#:
Spouse name:
Debtor on Tittle:
Debtor on Loan:
Relationship to client:
Has there been any physical attemps to obtain property?
If yes, please explain:                  :
DEBTOR EMPLOYMENT INFORMATION  
Last known employer:
Occupation:
Address:
City, State, ZIP
Phone:
LIENHOLDER INFORMATION  
Is there a lien on the property by a bank or finance company?
If Yes, Lienholder Name
City, State, ZIP
COLLATERAL INFORMATION  
Year, Make , Model:
Color:
VIN #:
Plate #:
State Plate Issue:
Description of Collateral: (100 Char)
Please explain in detail how this individual came into possession of your property:  (100 char)
LOAN INFORMATION  
Current balance owed:
Current value of property:
Monthly payment:
Months past due:
Amount past due:
Date last paid:
AGREEMENT

 I, here-in-after referred to as "Client" agree that I am entering into a contract with Reliable Recovery and Remarketing, Inc. A Florida Corporation (hereinafter referred to as RRR Corp.) (collectively the "Parties"). This contract contains the entire agreement and understanding between the Parties and supersedes all prior agreements and understandings, oral or written, concerning the matters covered by this agreement.

Client agrees and understands that each recovery is unique and RRR, Corp.'s "base fee" DOES NOT INCLUDE hardcore skips, investigation charges, field agent fees, fraud, identity theft, criminal enterprise, national database charges, etc. and the means necessary to recover your particular collateral. RRR Corp. "base fee" is just that, a "base fee" and the expenses encountered engaging in the recovery will result in an increase in the final charge to Client.

"Cases involving fraud, identity theft or criminal enterprise are billed on a sliding scale from 5% to 30% of the fair market value of the property recovered. The scale amount is determined by the degree of difficulty and risk involved in the investigation and the actual recovery, as well as the estimated time.

I agree that I have read and understand all the terms and conditions contained in the "Agreement" inmediately above, and agree to be legally bount by same.    Signature:
Date:
   

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