Company _____________________________
Address _____________________________
Mr/Ms ___________________________________
Telephone
_____________________________
Fax Number _____________________________
To: Sales Department
Roquemore & Roquemore, Inc.
800-500-7855 ext. 220, Fax 972-226-9720
Email: info@roquemore.com
Lenders Name ________________________________________________
Subjects Name ________________________________________________
Social Security # ________________________________________________
Loan Number ________________________________________________
Last Known
Mailing Address ________________________________________________
________________________________________________
Collateral ________________________________________________
Vin#
________________________________________________
Potential Loss ________________________________________________
Special
Instructions (or Check One) ____________________________________________
q Repo Only (Roquemore assigns the repo-confirmed address-no skip work)
q Repo On Sight (Roquemore Skips and assigns the repo to our agent.)
q Locate Collateral and Advise (Client handles the repo)*
q Locate Maker address and or phone number.
q Locate for Service
q Locate, Advise, Repo (Use Client’s Agent)** (Please provide agent information below)
(**)Agent Currently
Assigned:__________________________________Phone:__________________
Assignment Approved By_____________________________________ Date ___________________
(*) On those accounts where the
Client utilizes their own agent: We provide information on the
locate and advance
our file three(3) working days
while your agent runs the address. If
the collateral or party is not there or problems
develop, please notify us
immediately and we will work with the agent.
In some cases, we may ask permission to utilize
an alternate licensed and insured
contingency repossession agent.
Important! Please attach copies of the following:
Credit Application, Collector Notes, Loan Contract, Security Agreement,
and Title.