Online Assignments

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

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

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

Co-Maker:
Address: 
City:
 State:     Zip:
Phone:
Fax:
E-mail:
SSN and 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:
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:
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G.L. LaPierre & Company, Inc., Detective Agency
PO Box 843
Glendale, Rhode Island 02826

Phone: 800.216.7376
Fax: 401.568.2408


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