Get your case started today by completing this on-line application. Fields marked with * are required.

Commercial Collection AccountsJudgment Recovery Accounts

Commercial Collection Accounts
Case Information

 

The three step process.
Upon receiving your claim, we will immediately begin the debt collection process. If we have any questions, or require more information, we will contact you for clarification.

Please complete our simple three-step process for placing an account. This online process is the quickest way to appoint us as your collection agency, and it will allow us to start collecting your money today. Your account information will be held with the strictest confidence at Beacon Recovery Systems.

Your Information

 
*Company/Creditor Name:
*Phone:
 

*Attention:

Fax:
 
 
*Address(1):
*Email:
 
Address(2):
Additional Comments:
 
*City:
 
*State:
 
*Zip:
   
               

Debtor Information

*Debtor Company:
*Phone:
 

*Contact Person:

Fax:
 
 
*Address(1):
Account # :
 
Address(2):
*Principal Balance:
*City:
Date of Last Payment:
*State:
Oldest Invoice Date:
 
*Zip:
 
 
*Briefly describe your collection efforts and the debtor's reason for not paying:
*Do you have a Personal Guarantee?



 
*Do you have a credit application?



 
*Do you have a copy of a prior check?



 
*Do you have a copy of an invoice or statement of account?

 

*Is this account disputed?


 
               
 

Judgment Recovery Accounts
Case Information

Case Number (if known):

*Amount of judgment:

Amount collected to date:

*Date judgment was issued:

*State in which judgment was issued:
*Were you represented by an attorney?



Was your judgment awarded by default (defendant not present)?



Does judgment debtor (defendant) now reside in a different state?



*Name of judgment debtor:

*Last known address of judgment debtor:

 

 

*Description of my case (please be brief but thorough):

Contact Information

*Full name:
*Company:

*Street address:

 

 

*Telephone number:
*Email Address:

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