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1.    10 DAY FINAL NOTICE PLACEMENT
2.    IMMEDIATE COLLECTION ACTION


OUR INFORMATION 

NAME  
CLIENT CONTACT  
ADDRESS  
CITY  
STATE  
ZIP  
TELEPHONE  
FAX  
E-MAIL ADDRESS  
SUPPORTING  DOCUMENTATION TO  FOLLOW BY        Please select an option:  
    Email   Fax   Mail  
SUPPORTING  DOCUMENTATION   ATTACHED  
    Invoices   Statement   Contract   Credit Application   Correspondence   Other
PREFERRED METHOD   FOR   ACKNOWLEDGEMENT/   GENERAL UPDATES  
   

 

DEBTOR INFORMATION

STATION CALL   LETTERS   
COMPANY NAME  
ACCOUNT NUMBER  
ADDRESS  
CITY  
STATE  
ZIP  
ATTN  
TELEPHONE  
FAX  
E-MAIL ADDRESS  
AMOUNT  
INVOICE DATES  
COMMENTS  
   


 

This Claim Placement incorporates the following terms and conditions:

Claims against debtors in business will be handled by you under the agreed contingency rates.  We agree and understand that matters withdrawn after being placed for collection with you will be, at your discretion, subject to your regular schedule of charges.

When we accept the return or trade of merchandise in full or partial satisfaction, it is agreed we will be subject to commissions, but under ordinary circumstances, we would expect the commission rate to be predicated on one-half of the invoice value of the merchandise received.

If you cannot resolve the matter amicably, we authorize you, as our collection agent, to select an attorney listed and bonded by a reputable Law List Publisher, with the understanding the the name and address of said attorney(s) or agent(s) will be promptly furnished to us.

No attorney is authorized to commence suit in our behalf unless authorized to do so by us.  Your employment is that of our agent and with reference to those accounts forwarded, to conduct, as a convenience to us, the necessary correspondence with the understanding that the attorney(s) or local agent(s) are our direct representatives and we are free at all times to communicate directly with them if we desire to do so.  You are not to be responsible for any loss caused by the acts or omissions on the part of said attorney(s) or agent(s).

You shall have the right to endorse for deposit and collection, in our name and on our behalf, remittances received on accounts which we have placed with you for collection, and to deduct from such remittances your authorized charges, unless we have instructed you the contrary, remitting the difference to us within a 30 day period.