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Phone +1 973 895 4700
Phone +1 800 585 6004

Fax +1 973 895 4702

Email info@adkcollections.com

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Account Placement

Please accept and proceed with the past due account below, subject to your terms and conditions and rate schedule.

Debtor Information

Debtor Company Name

Customer #

Address

City

State

Zip

Country

Phone Number

Fax Number

Email Address

Contact Name

Principal's Name

Amount Due (please use numbers and periods only)

Experience:

Broken Promises

Ignores All Demands

Claims Inability to Pay

Disputed

NSF Checks

Declined Credit Card

Other

I will be forwarding:

Itemized Statement

Original Contract

Notes

Pertinent Correspondence

Documentation

Credit Application

Statements

Invoices

NSF Checks

Notes

Credit Reports

Correspondence

Personal Guaranty

Contract

Other

File Upload

File Upload

Comments

Creditor Information

Creditor Company Name

Creditor Contact

Address

City

State

Zip Code

Country

Phone Number

Fax Number

Email Address

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Address

1201 Sussex Turnpike
Randolph, NJ 07869

Phone +1 973 895 4700
Phone +1 800 585 6004

Fax +1 973 895 4702

Email info@adkcollections.com

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About ADK
Testimonials
Collection Services
Rates
FAQ

Client Portal
Account Placement
Report Payment Received
Pay Now
Locations
Consultation