REPOSSESSION CONTRACT
RIMROCK RECOVERY, LLC ● 1206 CORDOVA STREET ● BILLINGS, MONTANA 59101
RETURN CONTRACT VIA FAX: 406/896-1788 OR EMAIL: ORDERS@RIMROCKRECOVERY.COM
OFFICE USE ONLY
DATE REPOSSESSED DATE OF ORDER DEBTOR’S NAME DEBTOR’S STREET ADDRESS CITY PLACE OF EMPLOYMENT ADDITIONAL PERTINENT INFORMATION: STATE ZIP PHONE (incl. area code) DEBTOR’S SOCIAL SECURITY # CO-DEBTOR’S NAME (if applicable)
THIS CONTRACT AUTHORIZES RIMROCK RECOVERY, LLC TO ACT AS RECOVERY AGENT FOR SAID LIEN HOLDER TO COLLECT AND/OR REPOSSESS ON SIGHT FROM THE ABOVE NAMED DEBTOR, THE FOLLOWING VEHICLE IN HIS/HER POSSESSION:
YEAR:________________ COLOR:_______________ MAKE:__________________________ PLATE #:________________________ MODEL:____________________________ STATE:_____________________________
VIN:___________________________________________
AS LIEN HOLDER, WE AGREE TO INDEMNIFY AND HOLD RIMROCK RECOVERY, LLC HARMLESS FROM AND AGAINST ANY AND ALL CLAIMS, LOSSES, AND ACTIONS, EXCEPT UNLAWFUL ACTS OF THE FIRM. RIMROCK RECOVERY, LLC WILL NOT BE HELD LIABLE FOR THE MECHANICAL OPERATION OF THE ABOVE LISTED VEHICLE FOR INSURANCE PROTECTION, EXCEPT IN CASE OF NEGLECT. NOTHING CONTAINED HEREIN SHOULD BE CONSTRUED TO AUTHORIZE RECOVERY AGENT TO VIOLATE CITY, COUNTY, OR STATE LAWS. SIGNATURE AND NOTARY CERTIFIES LIEN HOLDER’S AUTHORIZATION FOR RECOVERY AGENT’S RIGHT TO IMMEDIATE POSSESSION OF THE ABOVE NAMED COLLATERAL. NOTARY PUBLIC REQUIRED
LENDER NAME/SALES LOT AUTHORIZEDSIGNOR (Print Name) SIGNATURE BUSINESS ADDRESS CITY PHONE STATE ZIP FAX
Subscribed and sworn to before me on this _____________ Day of _______________________, 20______
Notary Public for the State of _______________________ Residing at ______________________________________ My Commission Expires:___________________________
PLEASE INCLUDE A COPY OF LIEN FILING