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

If yes to previous question, provide details

Contact Name

Contact email

Contact phone number

Phone Type

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.

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?

Do you add any interest or finance charges?

If yes, please explain the basis for these amounts.

Do you add any other additional fees or charges?

If yes, please explain the basis for these amounts.

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?

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

Drop your files here

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?

Do you credit report on your accounts?

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

To collections, on a monthly basis.

Would you be willing to authorize legal action?

What are your expectations of PFC?

Please include any comments or questions.

Send me a copy of my responses

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