What's Up Placement Form

I'm sure to some people, Winter never seems to end. One thing we’ve been told people do not want to end is our Special Offer Fax Form.

Due to popular demand, we are again offering an additional 10% off our commission (not rate) on any account over $500 using this Special Placement Form. This form can only be used once.

Offer is good for no more than 3 placements and will end on April 9, 2010.

Creditor Information:

Company Name (Creditor):

Divisions:

Name:

Street Address:

City:

State:

Zip-Code:

E-Mail:

Phone:

Fax:

Debtor 1 Information:

Name:

Company Name (Debtor):

Account number:

Street Address:

City:

State:

Zip-Code:

Phone:

Amount Due:

Date of Last Charge:

Start immediately
Allow 10 Days

Debtor 2 Information:

Name:

Company Name (Debtor):

Account number:

Street Address:

City:

State:

Zip-Code:

Phone:

Amount Due:

Date of Last Charge:

Start immediately
Allow 10 Days

Debtor 3 Information:

Name:

Company Name (Debtor):

Account number:

Street Address:

City:

State:

Zip-Code:

Phone:

Amount Due:

Date of Last Charge:

Start immediately
Allow 10 Days

Answer to Brain Teaser:

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Mailing Address:

Office Address:

info@commercialcollection.com

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