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Consumer Placement

    Client Information

    • Consumer Placement

    • Debtor Information

    • YesNo

    • Mail ReturnedPhone DisconnectedDisputedCheck ReturnedInability to PayOther

    • Please Read Before Submitting:In submitting files for placement, the named client authorizes Your Collection Solution, Inc. to act as it's agent with respect to collections. Furthermore, client authorizes Your Collection Solution, Inc. to deposit all checks received into Your Collection Solution, Inc. Trust account. Your Collection Solution, Inc. will remit funds to client after deducting the agreed contingency fee. Disbursements will be paid biweekly when said monies have cleared our bank. In addition, client agrees to remit to Your Collection Solution, Inc. any monies received which were paid directly from the debtor less the agreed contingency fee.

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