Online Assignments

Submit your assignment online using the form below.


Lienholder:
Address:
City:
State:    Zip:
Phone:    Extension:
Fax: 
E-mail:
Collector: 

 

Debtor:
Address: 
City:
 State:     Zip:
Phone:
Fax:
E-mail:
SSN:
Date of Birth:

 

Debtor's POE:
Job Title: 
Address: 
City:
State:    Zip:
Phone:    Extension:

 

Co-Maker:
Address: 
City:
 State:     Zip:
Phone:
Fax:
E-mail:
SSN:
Date of Birth:

 

Co-Maker's POE:
Job Title: 
Address: 
City:
State:    Zip:
Phone:    Extension:

 

Collateral Year:
Collateral Make:
Collateral Model:
 
Plate:
State:
Color:
 
Key Numbers:
Vehicle Identification Number: 

 

Loan #:
Past Due Date: 
Past Due Amount: 
Monthly Payment:
Loan Balance: 

Assignment Type:

Note: 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 "Instructions" space below.
Authorized by:
Date:
Please type in the box the numbers and/or letters you see.
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JLJ Auto Recovery, LLC   |   Colorado Ph: 303-428-8956   |   Texas Ph: 903-340-6654