Placement Options
1. E-mail
New York & Connecticut
International
New York
Connecticut
London
716-832-4236
860-612-3191
Debt Information
Debtor Company:
Principal:
Debtor Account Number:
Address1:
Address2:
City:
State:
Country (International Only):
Postal Code (Zip):
Phone:
Fax:
E-Mail:
Balance due:
Date of last payment:
Oldest invoice date:
Comments:
Collateral File 1:
Collateral File 2:
Collateral File 3:
Collateral File 4:
Collateral File 5:
Submitter Information
Do you have a Personal Guarantee? Yes No Will you be forwarding additional documents? Yes No If Yes, how will you be forwarding? Fax Mail Send a Richmond North Associates 10-Day Final Notice to Debtor? No Yes
In submitting the above debtor balance for collection, the following is agreed to:
Richmond North Associates is authorized to commence collection action against the debtor. Submitter authorizes Richmond North Associates to accept payment, deposit funds collected and to select an attorney, if necessary.
The handling of this debtor is governed by Richmond North Associates' standard fee schedule. It is understood Richmond North Associates will not commence litigation without submitter's authorization.
Company Name:
Attention:
E-Mail:*
