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Post Office 637, Ridgecrest, California
93556-0637, 760-446-1927
Fax - 760-499-1414
No. 1
Year
Make
Model
Body Type
Date of Possession
Date Owner Billed
Towing
Storage
Repair
Date of Completion
Engine No
License Number
State
Expiration Year
VIN Number
No. 2
Year
Make
Model
Body Type
Date of Possession
Date Owner Billed
Towing
Storage
Repair
Date of Completion
Engine No
License Number
State
Expiration Year
VIN Number
No. 3
Year
Make
Model
Body Type
Date of Possession
Date Owner Billed
Towing
Storage
Repair
Date of Completion
Engine No
License Number
State
Expiration Year
VIN Number
No. 4
Year
Make
Model
Body Type
Date of Possession
Date Owner Billed
Towing
Storage
Repair
Date of Completion
Engine No
License Number
State
Expiration Year
VIN Number
No. 5
Year
Make
Model
Body Type
Date of Possession
Date Owner Billed
Towing
Storage
Repair
Date of Completion
Engine No
License Number
State
Expiration Year
VIN Number
No. 6
Year
Make
Body Type
Model
Date of Possession
Date Owner Billed
Towing
Storage
Repair
Date of Completion
Engine No
License Number
State
Expiration Year
VIN Number
Motorcycles And ATVs, We Must Have The Engine Numbers - We Cannot Process A Lien Without Them. Please Be Accurate!!
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Accept
When you submit this form to ASAP Lien Sales, Signed Or Not, It Is A Binding Contract. This form authorizes a lien to be processed by ASAP Lien Sales with the information you provide, and that you will hold ASAP Lien Sales harmless from any lawsuits, judgments, omissions or errors of any kind and under any circumstances. ASAP Lien Sales Is Providing A Secretarial Service To You And Will Be Liable For The Cost Of The Lien Sale Processing Only.
I Certify
I Certify
I certify under penalty of perjury under the laws of the State of California, that the information I have provided is true and correct.
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Thank You Very Much for the order!!
The ASAP Team
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335 W Ridgecrest Blvd.
Ridgecrest, CA 93555
mosautoliens@gmail.com
(760) 446-1927
(760) 499-1414
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