Company Name:                 
Your Name:                    
Phone Number:                 
E-Mail Address:               
Name of A/R Manager:          
A/R Mgr's Phone #:            
Range of Typical A/R Balance: 
Age of Typical Accounts:      
Approx. Number of Accts
Over 90 Days Past Due:        

Does your company extend credit?                 Yes   No
Do you require a completed credit application?   Yes   No
Are orders placed in writing?                    Yes   No
Are orders signed by the customer?               Yes   No

Do your forms disclose that you charge:
Interest?  Collection fees?  Both?  Neither?

Does your company undertake in-house collection? Yes   No
Does your company undertake outside collection?  Yes   No

Do you use a:
Collection agency?  Collection attorney?  Both?  Neither?

Typical minimum age of accounts turned over:

Typical fee charged you by outside agencies:

Typical rate of recovery on outside collections:

States where your customers are located:


Are your customers:
Businesses?  Individuals?  Both?

Is your company a cash or accrual taxpayer?

Would you like a free e-mail subscription to our
collection tips newsletter when it becomes available?
Yes   No