Online Assignments

Please complete the form below to submit an assignment:


*Lienholder:
Address:
City:
State:    Zip:
Phone:    Ext:
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:    Ext:

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

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

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:
*All fields marked with an asterisk are required


Bayou Recovery Service, LLC
4190 Bowden Rd.
Geismar, LA 70734

Phone: 225.293.4999
Fax: 225.706.4999

EMAIL




RSIG Member


AFA Member

Home  |   Assignments  |   Your Protection  |   Coverage Area  |   Services  |   Contact Us