Twenty-First Century Associates eBrochure

Building Our Future One Client At A Time

ONLINE PLACEMENT  FORM

Place your accounts online with our comprehensive placement form. Should you have any questions regarding the use of this form, please contact us at 201-678-1144 and we will be happy to help. 

Consumer Placement Form

For A Commercial Placement Form Please Click Here

IMMEDIATE COLLECTION     Check for 10-DAY FREE DEMAND SERVICE

DEBTOR
DATE                     AMOUNT    
  
TRADE STYLE DBA
DEBTOR FAX
ADDRESS
CITY                                     STATE        ZIP
      
HOME PHONE
CELL PHONE
WORK PHONE
SOCIAL SECURITY #        
 

DRIVERS LICENSE #                   ISSUING STATE

BANK                          ADDRESS
ACCOUNT NUMBER

 

DOCUMENTS (CHECK BELOW AND FORWARD BY MAIL)
  ITEMIZED STATEMENT CREDIT APPLICATION RETURNED CHECK(S)
  INVOICE COPIES CREDIT REPORTS COPY OF DEBTOR'S CHECK(S)
  PROOF OF DELIVERY PROMISSORY NOTE OR
OTHER INSTRUMENT
PERTINENT CORRESPONDENCE
  BANK OTHER

 

REMARKS


You hereby authorize Twenty-First Century Associates, to endorse in your company's name, and to negotiate or to deposit in any bank account of Twenty-First Century Associates. any and all checks, notes, drafts, bills or exchange or other orders for the payment of money payable or endorsed to you which come into Twenty-First Century Associates. possession by virtue of its acting as your collection agent, and to remit the proceeds to you, less any fees which may be due whether or not such fees relate to the claim for which the funds were received.   Twenty-First Century Associates. may use any funds collected to offset any open fees due Twenty-First Century Associates. for any account submitted to Twenty-First Century Associates. for collection.

 

SIMPLIFIED CONSUMER RATES

FLAT RATE

25% of Dollars Collected In House 

40% Legal Collections

Where necessary, Twenty-First Century Associates is authorized to forward this account to a bonded attorney.

CREDITOR

TELEPHONE NUMBER
REQUIRED
ADDRESS
CITY                                                STATE     ZIP
      
BY                                               TITLE
  
YOUR E-MAIL ADDRESS    REQUIRED
Twenty-First Century Associates will e-mail an acknowledgement.
   

 

 

 

 

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 TFC-266 Summit Avenue • Hackensack, NJ 07601 Tel. 201 678-1144 • Fax. 201 678-9088 • email: info@tfc-associates.com

Copyright 2003-2008 Twenty-First Century Associates ALL RIGHTS RESERVED