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Priority Collections, Inc.
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Commercial Debt Collection Speacialists

 
  Immediate claim placement
Please proceed with the immediate collection on the account listed. We agree to notify you promptly of any payments received. We agree to pay your fees on any payments made from this date of assignment forward, cancelled claims are subject to rate equal to prevailing amount of claim. We understand agency retains interest collected unless other arrangements are made. Agency is authorized to endorse client’s name and deposit funds into agency trust account. Agency is authorized to forward claim to outside counsel. no litigation will be filed without prior client authorization.
Your Debtor’s Information
1. Debtor
2. Debtor
Address
Address
City
City
State
State
Zip Code
Zip Code
Name of Contact
Name of Contact
Telephone
Telephone
Your Customer Number
Your Customer Number
Balance Due
Balance Due
Date of Last Charge
Select Date
Date of Last Charge
Select Date
We Have Enclosed the Following Items

We Have Enclosed
the
Following Items

Debtor Entity *
Debtor Entity
Creditor (Your) Information
E-mail Address: *
Name *
Company Name*
Telephone *
Address
City
State
Zip Code
To: *





* Required Feilds   May 26, 2009

21818 Craggy View Street, Suite 201  • Chatsworth, California 91311-2952 • Telephone (818) 280-0100 • Fax (818) 280-0900
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