Step 1 of 1100%There was a problem with your submission. Errors have been highlighted below.Assigning Company Name*0 of undefined max charactersComplete Company Address*0 of undefined max charactersAuthorized Representative Name*FirstLastDirect Phone Number*Email*Debtor Name*FirstLastDebtor's Complete Home Address*0 of undefined max charactersDebtor's Home Phone*Debtor's Employer & Complete Address*0 of undefined max charactersCollateral Information*Passenger VehicleMotorcycleThird ChoiceRV/Camper/BusPick Up TruckWatercraftSemi/Dump TruckSUV/VanPowersports VehicleCommercial/Farm EquipmentOtherYear/Make/Model*0 of undefined max charactersPlate Number & State Of Registration*0 of undefined max charactersNote: Should you have any information regarding family members, relatives of the debtor, or any unique or defining information that would be helpful in aiding us in the recovery of your vehicle, please enter that information in the space below.*This is your authorization to repossess, store and transport across state lines the above-described collateral which is covered by a defaulted installment contract or lease agreement. We name Miguel's Custom Towing and Recovery as our exclusive agents for repossessing the above-described collateral. This means that any agent we have previously engaged is no longer authorized to repossess this collateral unless they are subsequently authorized to do so by Miguel's Custom Towing and Recovery. We agree to indemnify, defend, and save you harmless from and against any and all claims, losses, and actions, except for your unauthorized efforts and/or actions which may be acts of our company, its officers, employees or agents. We understand that Miguel's Custom Towing and Recovery under its corporate charter, is bound by the laws of the State of Florida, and its services are rendered subject to the jurisdiction of the laws of that 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 by A Miguel's Custom Towing and Recovery anyone else is understood to mean but is not limited to, body shops, police impound lots, other repossessors or to any facility under our direct or indirect control. You must agree to the statement above*I agreeMiguels Custom Shop & Towing - R330039Security Check*1 + 1 =
