MDR Services Inc. Repossessions in Maryland

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Online Assignments

Complete the online assignment form below.
If you have a Re-Pros or RDN login, you may also choose to use the links to the left to submit your assignment.

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

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:
Address:
City:
State:	Zip:
Phone:	Extension:

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

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

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

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

Please provide information and instructions in this space:

This is authorization for MDR Services, Inc. to act as our agent to collect or repossess the above collateral. We agree to indemnify and hold you harmless from and against any and all claims, damages, losses and actions including reasonable attorney fees, resulting from and arising out of your efforts to collect and or repossess claims, except, however, as such may be caused by or arise out of negligence or unauthorized acts on the part of you, your company, its officers, employees or its agents.

Authorized by:
Date:
Please type in the box the numbers and/or letters you see. If you are having trouble viewing this image click to generate another.

MDR Services Inc.
Corporate Headquarters
PO Box 126
Queen Anne, MD 21657

MDR Services Inc.
207 Bell St.
Ridgely, MD 21660

MDR Services Inc.
7806 Malcolm Rd.
Clinton, MD 20735

Toll-Free Ph: 800.529.6616
Local Ph: 410.634.1775
Fax: 410.634.1776

EMAIL