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Fill out this form, then press "Submit" for Instant Assignment to Interstate Adjusters

This is authorization to act as our agent to collect or reposses the above collateral. We agree to indemnify, and hold 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 reposses 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.