Hire Us To Collect Payments From Your Debtors

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Client Information:

Name(Required)

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Debtor Information:

Amount of Placement: $(Required)

Last Payment Date(Required)

Last Charge Date(Required)

Name(Required)

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Email Address(Required)

Basis of Account(Required)

File

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Collection Agreement

We assign the above account(s) to Commercial Collections of America LLC (CCA) for collection. As our agent, CCA is authorized to proceed at once to enforce the collection of the account for a contingent fee of 30%. CCA or CCA’s attorneys are authorized to accept cash payments and endorse checks, notes, money orders, cashier’s checks, or other drafts for deposit—the net proceeds of which CCA is to remit to us. Special authorization is required to file suit or compromise the balance. In addition, a separate fee will be required if a lawsuit is necessary, which will have to be negotiated. It is understood that we will refer all contacts from the debtor directly to CCA’s office. We will immediately notify CCA of any payment made directly to our office. CCA will be entitled to the full 30% fee for any payment that is made to your office or paid directly to CCA’s office after the date of assignment. All interest collected is retained by CCA.