Professional, Affordable Collection Services
Billings, MT: (406) 252-6371
Toll Free: 1-800-231-1971

Claim Placement Form

Fill out and Submit the Form below to Place a Claim OR Fill out our PDF form that you can save, email, mail or fax back to us.

Access the PDF Here

Please collect the account contained in this submission. It is correct, just and unpaid, and we can furnish an itemized statement upon request. This account has not been or is not now listed with other collectors or with attorneys to our knowledge. We agree to report to you promptly all payments made directly to us on this account. When this account cannot be collected by peaceable means and your investigation and best judgment indicates that legal action is advisable, you are hereby authorized to assign this account to any person or firm for purposes of legal action, reserving the equitable ownership of this account; and you are hereby further authorized to accept assignments from other creditors of the person or persons listed below to me or for the purpose of legal action only.
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Client Information



Debtor's Information
Agreement for Collection Services

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