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Business Name                                                     Contact Person
How many accounts do you need help with that have not been sent to another agency?  
A/R Worksheet                               Downloadable A/R Worksheet if you prefer to Print and Fax
Our Fixed Fee Per Account Programs yield the highest recoveries in the industry at fees typically less than 10%.  With that being said, it's all about your accounts and your exact need!  In order to direct you to the correct program with specific pricing we need you to answer the questions below keeping in mind we accept accounts up to 2 to 3 years old and down to a minimum balance of $50.00.  Please remember the more accounts you have, the lower the cost.  Once you have filled out the form below, right click it and print it to retain a copy for your records.  Next click "Submit" and your CAD representative or someone else from our company will get back with you ASAP. 
Phone                            Email                                                         CAD Rep
The majority of your delinquent accounts fall into which of the following categories?
How many new delinquent accounts do you anticipate submitting on monthly basis?
Please enter the dollar amount on each of the accounts you need help with, i.e., $250.00, $795.50, $1,500.75.  If you have more than 25 accounts simply give us a sample of as many as possible.

Additional Comments
Please calculate and enter the total dollar amount on all of the above accounts?  
How many accounts would you like to pull from your current agency and forward to CAD?