Collection Agency - Chasemax, Inc.

New Placement

Your Company Contact Information

Company Name
Contact Name
Title
Address
City
State
Zip
Phone
Fax
e-mail
	New Placement Secondary Placement
Sales Rep Name

Debtor Information

Company Name
Contact Name
Amount
Phone Number
City
State
Fax
Date of last sale or service

Any additional Information

Chasemax, Inc. Terms and Conditions for Commercial Account Placements Chasemax, Inc. (“CHASEMAX”) and CLIENT agrees that the accounts placed with CHASEMAX are subject to the terms and conditions of the following agreement between them: 1. All accounts placed from CLIENT to CHASEMAX will be in compliance with federal, state and local laws and regulations. CLIENT will refer to CHASEMAX for collection services only commercial accounts which are due and owing to CLIENT. No account will be placed by CLIENT if the debt was incurred by the debtor for personal, family or household purposes. 2. All accounts placed shall be placed by CLIENT utilizing the CHASEMAX Commercial Collection Division Placement Form. Placement of accounts for collection shall signify CLIENT’S acceptance of these Terms and Conditions. 3. CLIENT warrants that the balances on all accounts placed are true and correct and that any interest or additional charges added to any account balance by CLIENT, or which CLIENT directs CHASEMAX to add, are authorized by contract or are otherwise authorized by law. 4. CLIENT authorizes CHASEMAX to endorse all checks, money orders, drafts, cash, etc. payable to CLIENT for the purpose of deposit into a separate trust account maintained by CHASEMAX for its clients. 5. CLIENT shall promptly notify CHASEMAX of payments, adjustments and disputes received directly by CLIENT on accounts placed for collection. Failure to provide such information promptly may result in a fine. CLIENT shall be responsible for all fines for information not provided to CHASEMAX. 6. The fees payable to CHASEMAX for its services are set forth on Exhibit A hereto. 7. CHASEMAX shall provide CLIENT a detailed monthly invoice. All collections made by CHASEMAX on CLIENT’S accounts shall be remitted to CLIENT less the collection fees due CHASEMAX by the 10th day of each month for the prior month’s collections. In the event that the amount collected by CHASEMAX is not sufficient to pay all amounts due, CHASEMAX shall invoice CLIENT for any unpaid amount due. All CHASEMAX invoices are due and payable upon receipt by CLIENT. 8. Any negotiable instrument that is submitted by a debtor, which is returned unpaid, will be charged back to CLIENT, or CHASEMAX in the case of a payment to Creditor, and adjustments as appropriate shall be made. 9. A cancellation fee will be charged on any account that is inappropriately cancelled or due to interference from client once CHASEMAX has been retained. Cancellation fee will be full fee due or 15% of balance. Waiver of Cancellation fees will be based upon just cause; our corporate attorneys will review any discrepancies. In event litigation deems necessary, unless Harris County, Houston, Texas we direct and authorize you, as our attorney in fact, to send the above account to an attorney, designed by us, in the county of Debtor, and whose name appears in the Columbia Law List Publication, according to prevailing rates in the county.

Please select to "YES" to indicate you agree to the above Terms amd Conditions

Primary Placements

Primary placements are defined as accounts that have never been placed with a collection agency by Client or any prior holder of the account being placed, and located within the United States. Contingent fee percentages are based on the age of the account as of the date of placement. For purpose of determining the age of delinquency, the last date of sale or service is used.

Secondary Placements

Secondary placements are defined as accounts that have been placed with one collection agency by Client or any prior holder of the account being placed prior to placement with Chasemax.