New Client Application

PFC reserves the right to decline to provide any services for any reason. Completion of this application does not imply any contractual obligations, confidentiality, or non-disclosure agreement.

Company Name*

Company City & State*

Does your company provide services in other states*

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If yes to previous question, provide details*

Contact Name*

Contact email*

Contact phone number*

Phone Type*

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Were you referred to PFC? If so by whom?*

Your Company's Accounts

Can you place accounts electronically?*

PFC does not place accounts manually. PFC offers a web portal for secure transfer of your placement files.

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What type of services do you provide?*

How does your debt arise?

What will trigger you sending an account to PFC?*

Do you have written contracts for these services?*

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Do you add any interest or finance charges?*

If yes, please explain the basis for these amounts.

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Do you add any other additional fees or charges?*

If yes, please explain the basis for these amounts.

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Do you send billing statements on your accounts?*

Do you send billing statements making consumers aware of the balance due, prior to sending the account to collections?

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File Attachments

Please provide sample copies of your contract and billing statements, if applicable.

Drag and drop files here or

Are you able to provide PFC with proof of debts?*

Collection regulations require PFC to respond to disputes within 30 days. Are you able to provide PFC with proof and/or documentation of all debts within 30 days of request?

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Do you credit report on your accounts?*

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Per month, how many accounts do you have to send?*

To collections, on a monthly basis.

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Would you be willing to authorize legal action?*

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What are your expectations of PFC?*

Please include any comments or questions.

Send me a copy of my responses

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