PLACE ACCOUNT ONLINE

You can enter each account for placement, one at a time, through the online form below. Please call us toll free at 877-205-2846 for spreadsheet placements or FTP upload instructions.

You will receive a confirmation that your submission was received, and we will fax you an acknowledgement report when your business has been entered into our system.

We will begin working your business immediately upon upload into our system.

To place an account by fax please click here , complete the PDF form and fax it to 614-336-1150.

 

Place Account Online Form
Part 1 (Your Information)
Client Name:	Client Contact Email Address:
	required field
Client Phone:	Client Fax:
Part 2 (Debtor Information)
Debtor Name:	Debtor Address:
Debtor Main Contact:	Debtor Phone #:
Debtor Fax:	Debtor City / State / Zip:
Is there a Signed Personal Guarantee?	Debtor Amount Due:
Yes No	$
Is there a Signed Contract?	Date Last Invoice:
Yes No
Debtor Account #:	Sensitive Account?
	Yes No
Debtor E-Mail Address:
Special Instructions & Notes:
By checking "I Accept" you agree to our Terms and Conditions I Accept