YOUR EMAIL ADDRESS
DBA
OWED:
ADDRESS:
TELEPHONE:
FAX:
OF BUSINESS:
OWNER'S NAME:
PRODUCT SOLD
OLDEST INVOICE:
INVOICE #:
CHECK #:
EXPERIENCE :
BROKEN PROMISES
PARTIAL PAYMENTS
NSF CHECK(S)
DISPUTE-SEE REMARKS
STATMENTS(S)
INVOICE(S)
NOTES(S)
NSF CHECK(S)
CONTRACT
REMARKS:
ACCOUNT BEEN IN
COLLECTIONS BEFORE?
YES
NO
We refer the above to you for collection. You, as our agent, are authorized to proceed at once to collect the account. Commission will be charged on the accounts collected, paid direct or settled by return of merchandise, in the event litigation is deemed necessary we direct you, as our agent, to send the account to an attorney designated by you. You are authorized to accept payments and to endorse checks, notes, money orders or drafts for deposit, the net proceeds of which you are to remit to us. Special authorization is required to file suit or compromise. We agree to report any contact or payment from the debt immediately. Placing of accounts signifies agreement to our preferred client rates.
FIRM:
ADDRESS:
CITY:
TELEPHONE:
AUTHORIZED SIGNER:
DATE:
PLEASE TAKE IMMEDIATE ACTION!
Call us now at
Tel
631 941 3300
Fax
631-706-3023
Email
Info@usacollector.net
Copyrights 2006 Benjamin & Williams Credit Investigators, Inc.
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