This is your authorization to act as our agents to repossess, on sight, the above described collateral which is covered
by a defaulted installment contract.  We agree to indemnify and hold you harmless from and against all claims,
damages, losses  and actions resulting from or arising out of your efforts to repossess the above described collateral,
except however, such as may be caused or arise out of the negligence or unauthorized or illegal acts of your firm, its’
officers, employees or agents. Nothing contained herein shall be construed to authorize the violation of the laws of
your state."We" also agree that if the debtor or his agent(s) should surrender the collateral to "anyone" else during the
term of this agreement it will be deemed to have been repossessed, and invoiced as such. "Anyone" else is understood
to mean but is not limited to, body shops, police impound lots, other repossession companies, or to any facility
under our direct or indirect control.
By signing this authorization "We" agree to these terms.
X                                                       X                                                   /       /      
Printed Name                                 Signature                        Date
BSM RECOVERY
PH#  512-965-7376
FAX# 512-949-5062
EMAIL: info@bsmrecovery.com
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
LIEN HOLDER INFO:
Company Name:_______________________________________
Contact Person: __________________________________________
Contact Phone Number: _________________________________
Fax Number: __________________________________________
Email: _________________________________________________
Address: ___________________________________________________________
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

VEHICLE INFO:
YEAR______MAKE_______________ MODEL____________COLOR ________
VIN_______________________________  LICENSE PLATE_____________
DEBTOR INFO:
NAME(S): _____________________________ PHONE NUMBER:_______________
D.O.B:___________SSN#:_____________ EMPLOYER:___________________

POSSIBLE VEHICLE/DEBTOR ADDRESS:
ADDRESS: _____________________________ CITY_______________ ZIP ______
ADDRESS: _____________________________ CITY_______________ ZIP ______

NOTES_____________________________________________________________
____________________________________________________________________
REPOSSESSION AUTHORIZATION