Leinholder Phone with Extension
Leinholder Contact Person
Debtor SocialSecurity Number
Comaker SocialSecurity Number
Comaker Employer Phone Number
We, the above named client, agree to indemnify and hold you harmless from and against any and all claims, damages, losses and actions resulting and arising out of repossession of, or your effort to repossess this unit, except such as may be caused by or arise out of negligence or unauthorized illegal acts. We understand that Dixon Recovery, LLC does not accept assignments on a contingency basis.