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Date
Debtor
Contact Name
Total Balance Due
Company name
Street Address
City/State
Zip/Postal Code
Country
Phone
FAX
E-mail

Company Information

Your Company
Company Street Address
City
State/Province
Zip/Postal Code
Country
Work Phone
FAX
E-mail

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10-DAY FREE DEMAND – IF YOU RECEIVE PAYMENT WITHIN 10 DAYS OF PLACEMENT THERE IS NO COMMISSION CHARGED COPIES OF INVOICES AND  SUPPORT , INCLUDING ALL SHIPPING DOCUMENTS ARE USUALLY NECESSARY TO MAXIMIZE  RECOVERY ANY PAYMENTS RECEIVED BY YOUR OFFICE AFTER PLACEMENT MUST BE REPORTED TO US PROMPTLY AND ARE FULLY COMMISSIONABLE. IT IS HELPFUL TO INCLUDE COPIES OF PERTINENT CORRESPONDENCE AND DETAILS IF CLAIM IS DISPUTED All claims accepted under our Standard Terms and Conditions of engagement