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Proud member of
Allied Finance Adjusters

 

 

Dakota West Repossessions,Inc.
P.O. Box 9304
Rapid City, SD 57709

Ph: 605.348.3731
Fax: 605.394.9438

Online Assignment Form

* Required Fields
*Lienholder:
*Address
*City:
*State:  *Zip:
*Phone:    Ext:
Fax:
*E-mail:
*Collector:
*Debtor:
*Address:
*City:
*State:  * Zip:
Phone:
E-mail:
*SS#:
*DOB:
*Employment:
Address:
City:
State:    Zip:
Phone:    Ext:
Fax:
*Collateral (Year, Make, Model):
Plate, State & Color:
Key Codes:
* VIN:
*Loan Acct #:
Past Due Date:
Mo Paymt:
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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