Let us know who your coordinator is and where to find your funds every month
To start, enter your email so we know where to contact you going forward:
Sign in to Google to save your progress. Learn more
Email *
Let's start with the person at your company who is the main point of contact in case there's a question related to your accounts in collections...
This is the person in charge of your collections. For example, when someone disputes, or there's a withdrawal etc. this is who handles these situations at your company
When the Collection Agency needs to contact you for something specifically about your accounts in collections, what's the full name of the person they should reach at your company? *
When they need to contact this person, what phone number should they call? *
What's the email address of your Coordinator? *
And when they need to mail something to you, what mailing address should they use for you? *
Last thing: Where to send your funds on the 22nd day of every month.
If you'd prefer to submit your banking information later or another way, that's fine! Scroll to the bottom of the form and click SUBMIT.
What's the bank name?
What's the recipient's full name?
What's the routing number?
What's the account number?
What's the beneficiary name? (Your legal company name attached to the bank account)
What's the beneficiary's address?
Any other information you'd like to share that may be helpful? (if no, leave blank)
That's it! Thank you for submitting this information so we can get everything up and running for you. Click the SUBMIT button now.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Diplomatic AI. Report Abuse