REAL TIME LLC™ www.creditresolution.com^©

JUDGMENT COLLECTION, ACCOUNTS RECEIVABLE COLLECTIONS and CONSULTING SERVICES

Telephone: 718-355-9095 - Facsimile: 347-612-4686 – solutions@creditresolution.com - www.creditresolution.com

IMMEDIATE COLLECTION AUTHORIZATION
I / we hereby authorize Credit Resolution to initiate immediate collection action to recover unpaid billings and accounts receivable items from the obligor(s) named below. I also authorize Credit Resolution to bill our company in the event we receive direct payments from the obligor(s) named in this collection account placement in the event that any payment is made directly to our company by the obligor(s) named in this document. This agreement will remain in effect for a period not less than twelve months unless no activity is recorded and reported by Credit Resolution on behalf of our company or our company receives a written notice of cancellation from Credit Resolution, or until we or our company submit a written request to close this file based on Credit Resolution’s having deemed the same uncollectible. Submission of this collection placement order does not require a signature.
CREDITOR INFORMATION
Company Name:
Business type:		Current Client	New Client
Authorized on (date):	Today’s date:
Contact Name:		Title
Email Address:		SPAM Guard:
Telephone:		Extension
Direct Line:		Best time?
Mobile or Pager		Best time?
Facsimile:
Second Facsimile:		Location:
Address		Suite or Floor
Address Line 2		Additional Info:
City		State + Zip:
Tax ID Number:		Notes:
URL (Web Site):		Notes:
Special Notes:

DEBTOR – OBLIGOR INFORMATION

Company Name:

Notes on Relationship &

Do you wish to save it?

Yes

No

Notes - Instructions:

Signed agreement?

Yes

No

Business Type Corp., Sole Prop., LLC, LP, etc.

Account No.:

Contact Name:

Title:

Email Address:

Problems?

Telephone:

Extension

Direct Line:

Best time?

Mobile or Pager

Best time?

Facsimile:

Second Facsimile:

Location:

Address

Suite or Floor

Address Line 2

Additional Info:

City

State + Zip:

Tax ID Number:

Notes:

Debtor’s Web Site:

Notes:

Business License

State of Issue:

Original Amount Due:

Balance Due Now:

Invoice Numbers:

Invoice Date:

Invoice Numbers:

Invoice Date:

Invoice Numbers:

Invoice Date:

Invoice Numbers:

Invoice Date:

Invoice Numbers:

Invoice Date:

Invoice Numbers:

Invoice Date:

Special Instructions:

Personal Guarantee 1

Social Security#

Personal Guarantee 2

Social Security#

Did you turn this claim over to any other agency? If so, Name:

Submitted on:

Bank Account No.:

Bank Name:

Please attach copies of invoices, correspondence, checks and email this completed form to us.

Please review our current collection fees posted regularly on our site: www.creditresolution.com

SCHEDULE OF COMMERCIAL RATES On actual amounts collected/received
Placement Balance	Rate (%)
$ 0 -- 2,000	40
2,001 – 20,000	25
20,001 & Above	20
Rates are  for First Placements only Secondary Placements, Judgments or Claims against individuals are collected on a 50% contingency Matters requiring legal action are collected on a 40% Contingency

Client knows agrees and understands that the assignment or forwarding of any matter prior to or already in judgment stage for collection is limited to collection efforts and legal action (when necessary and authorized only for that matter) or enforcement of the judgment in question. Client further understands that such action does not cover the cost or legal preparation for a defense of a counter claim against the client by the other side. Costs and fees due for any other counter claim action to defend a counter suit or legal action and costs as well as fees in the event the integrity of any judgment is compromised by the courts.

IN JUDGMENT MATTERS ONLY: This agreement does not include and specifically disclaims any obligation on the part of the assignee or its agents or attorneys to represent the plaintiff or judgment creditor in the original lawsuit or in any action to protect the integrity of any judgment or to bring any affirmation in opposition to any order to show cause that may be brought to vacate any of the judgments assigned.

FOR ALL COLLECTION MATTERS: Client knows and understands that as of the date of this contract any monies paid directly to the Client by any debtor represented will be immediately forwarded to Real Time, LLC T/A www.creditresolution.com and subject to the percentage agreed upon as if these funds were paid to Real Time, LLC T/A www.creditresolution.com directly. All funds collected are remitted to our clients on a monthly basis from the accounts of Real Time, LLC T/A www.creditresolution.com. There is no account maintenance charge for collection clients.

BY ENTERING AND SUBMITTING INFORMATION ON THIS FORM YOU AGREE TO THE TERMS CONTAINED HEREIN AND IN OUR WEB SITE www.creditresolution.com.  FEEL FREE TO CONTACT US ON THE TELEPHONE OR BY EMAIL IF YOU NEED MORE INFORMATION BEFORE MOVING FORWARD WITH THIS CLAIM.

Phone 718-355-9095 Fax 347-612-4686 mailto:solutions@creditresolution.com or judgmentcollections@gmail.com