NORTH VALLEY RECOVERY

client name
account#
Email Address:
address
city
state
zip
phone
fax
debtor last name
debtor first name
home address
city
zip
phone
additional phone (cell)
DOB
SSN
DL#
employer name
employer address
state
zip
employer phone#
co-debtor last name
co-debtor first name
co-debtor address
city
zip
co-debtor phone#
co-debtor alt phone (cell)
co-debtor employer
employer address
city
state
zip
employer phone#
account type voluntary
involuntary
additional info
vin #
year
make
model
color
engine type
license plate #
state
experation
STANDARD HOLD HARMLESS AGREEMENT This is your authorization to act as our agents to repossess on sight all collateral which we assign to you either written or verbally. We agree to indemnify and save you harmless from any and all claims, damages, losses, or action resulting from arising out of our efforts to collect the claims, except, however, such as may be caused by or arise out of the negligence or unauthorized acts of your company, it's officers, or employees of such agents.

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