CannaBIZ Collects | Bulk Claim Submission

Please make sure you have filled out our CannaBIZ Collects fee agreement so we can process and work on your claims. If you do not have our fee agreement, please visit www.cannabizcollects.com/inquiries to request from our team. Thanks!

Your Legal Business Name

Kindly ensure that if you are submitting accounts for multiple entities or different locations with distinct accounting requirements, you submit a separate form for each entity or location.

Date

Name

First NameLast Name

Title/ Position

Email

Please be aware that we can only utilize a single primary contact email address. In case there are multiple emails to be cc'ed, please include a catch-all email, such as ar@company.com.

Were you referred to CannaBIZ Collects?

Please note company name or individual who referred you to work with CannaBIZ Collects

Direct Phone Number

Format: (000) 000-0000.

Office Phone Number

Format: (000) 000-0000.

Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Your Company's Billing/ AP Contact Email

example@example.com

What Industry are you in? (Best fit to your business)

Do you authorize: a) Cannabiz to act as your agent to manage the claims you are submitting and agree that claims cannot be reversed once they are submitted. b) Any accounts that were actually paid prior to placement will be subject to a flat $500/claim finder's fee. c) Cannabiz retains the authority to disclose pertinent claim information to third parties, encompassing credit bureaus and credit agencies, including any prior claims previously submitted by the Client. Cannabiz commits to ensuring the anonymization of Client data, safeguarding the Client's identity remains confidential and unidentifiable as the primary source of said data

Bulk Claim Spreadsheet Upload

File types: xls, xlsx

What is the currency of this claim?

Accompanying Documentation (I.e. Invoices, contracts, email/text communication etc). Please ensure that each file is named exactly the same as the debtor company listed in each row of the Bulk Claim Spreadsheet.

File types: pdf, doc, docx, xls, xlsx, csv, txt, rtf, html, zip, mp3, wma, mpg, flv, avi, jpg, jpeg, png, gif

How user-friendly overall was this submission process?

1 is Worst, 5 is Best