Skip to content
Contact us:
603.856.3762
|
info@corpintelsvs.com
HOME
ABOUT
SERVICES
COMMERCIAL COLLECTIONS
FINANCIAL REPORTING
REQUEST FORMS
ASSET LIABILITY INVESTIGATION REPORT
COLLECTIONS PLACEMENT
TESTIMONIALS
BLOG
CONTACT US
Collection Placement Form
mvisconti
2019-03-03T22:08:14+00:00
Collection Placement Form
Your Company Name
Your Name
First
Last
Phone
Email
Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Business Debtor Name
Contact Name
First
Last
Position Held at Company
Phone
Email
Address of Business
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Date of Last Invoice
Date Format: MM slash DD slash YYYY
Business's Website
Amount Due: Principle
Amount Due: Interest
Amount Due: Total
Bank Name:
Bank Account Number:
Does this account involve a dispute? If so, please explain:
Please Provide Backup (if available)
Credit Application
Personal Guarantee
Purchase Order / Bill of Lading
Judgement
Bad Check (copy)
Experience with customer
Debtor Avoiding Calls
Refuse to Return Calls
Broken Promises
Done Everything We Can. Will Not Pay.
Bad Check
File
Drop files here or
CAPTCHA
Phone
This field is for validation purposes and should be left unchanged.
