Proud member of:
American Recovery Association &
Rocky Mountain Repossessors Association





Pennsylvania Repos
Maryland Repos


C & S Towing and Recovery
1355 S George Street
York, PA 17403

30 Stenerson Lane
Cockeysville, MD 21030

Ph: 717.848.8220
Fax: 717.848.8765

Online Assignment Form

*All fields marked with an asterisk are required

*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:
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:

Please type in the box the numbers and/or letters you see.
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