PLACE AN ACCOUNT FOR COLLECTIONS ONLINE

Place An Account For Recovery Online Shane Underwood - Asset Recovery Specialist (469) 424-3033 Ext. 573 s.underwood@tuckeralbin.com

Enter Company Info Below:
Contact Name*

PrefixFirst NameLast Name
Name of Company:*
Company Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Debtor Company Name*
Name of Company
Debtor Company Address*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Debtor Phone Number*
Please enter a valid phone number.
Debtor Email*
example@example.com
Debtor Title & Name*

PrefixFirst NameLast Name
Additional Debtor Information
(Additional contact names, phone numbers, job site location, shipping info, additional email addresses, etc.)
Principal Balance Owed*
Exact Amount Due
Last Date of Sale or Payment*

MonthDayYear
Date
Late Fees / Finance Charges Accrued*
Amount, if any
Total Amount Due*
Total Amount Due (Principal Amount + Fees / Finance Charges)
Collection Rate
Rate Percentage (If Known)
Debt Validation Documents

Documents supporting amount owed i.e.; Invoices, Statements, Contracts, Liens, etc.
Cancelof
*Submitting this form will place the above debtor into collections with Tucker Albin & Associates. Immediate contact will be made with this debtor. If they attempt to contact you in any way please refer them back to Tucker Albin & Associates. I appreciate the opportunity and please do not hesitate to reach out with any further questions! **Tucker Albin & Associates offers 100% Contingency based Services. No Collection, No Charge!

Shane Underwood (469) 424-3033 Ext. 573 - s.underwood@tuckeralbin.com
Tucker Albin & Associates

www.tuckeralbin.com
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Place An Account For Recovery Online Shane Underwood - Asset Recovery Specialist (469) 424-3033 Ext. 573 s.underwood@tuckeralbin.com

Tucker Albin & Associates