Hold Harmless Form Posted November 22nd, 2013 by tcooper-admin. Associates Asset Recovery, LLC Hold Harmless FormToday's Date Date Format: MM slash DD slash YYYY Your Name* First Last Your Email* Client Name*Authorized Contact Name* First Last Authorized Contact Number*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Date of Order* Date Format: MM slash DD slash YYYY Date Repossessed Date Format: MM slash DD slash YYYY Debtor's Name* First Last Debtor's Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Co-Debtor First Last Phone*Email Place of Employment*Any Other Pertinent InformationVehicle InformationThis is your authorization to act as our agent to collect and/or repossess on sight. The above named, who has his/her possession:Year*Make*Model*Color*Plate #*Vin #*This will certify that we have the right to the immediate possession of the above named collateral. We agree to indemnify and hold you harmless from and against any and all claims, losses, and actions, except unlawful acts of your firm. You will not be held liable for the mechanical operation of the vehicle as listed above, for insurance protection except in case of your neglect. Nothing contained herein should be construed to authorize you to violate City, County or State laws. Your special immediate efforts with be appreciated. Please acknowledge and keep us informed. Additionally, you will be required to provide information such as SSN# and also, we will need a notarized form before being able to complete repossession. You can print the form out here - Hold Harmless Form.Would you like to receive emails from us in the future?*YesNoEmailThis field is for validation purposes and should be left unchanged.