If you're a
current client and wish to monitor our progress or pull instant reports,
please contact our office.
Click here to place your
past-due B2B A/R accounts with us for fast collection.
Miller, Ross &
Goldman
Is A Proud Member Of:
The
Commercial Law
League Of America
The
American Collectors Association International
The
Int'l Association of Commercial Collectors
Commercial Applicant Inquiry
Please use the form below to request
our inquiry on a legitimate business applicant. We must have a
valid copy of the credit application in order to fulfill this
request, without exception.
If you are a current client
utilizing our commercial debt collection services, we may provide
this service as a free value-added service dependent upon active
volume or value of accounts placed If you're not our client
yet, we'd welcome the opportunity to demonstrate our debt collection
expertise if the need exists. Otherwise, our fee for this
service is $125.00 per applicant inquiry. You may submit up to
5 inquiries per form.
*Required Fields
Client Info
Client Status*
Not
A Current
Client
Current
Client
Client Company*
Contact Name & Title*
Contact Phone*
x
Contact Fax*
Street Address*
City, State/Province,
Zip/Postal Code*
Country/Region
Email Address*
Industry
Goods & Services
Applicant 1 Info*
Company Name*
Contact Name,
Title*
Street Address*
City, State/Province,
Zip/Postal Code*
Country/Region
Phone*
x
Fax
E-Mail Address
Credit Amount
Requested*
Comments
Personal Guarantor?
YesNo
Last
Debtor ?
If this
is the last debtor, please scroll to the bottom of this
form to submit. Otherwise please continue with 2nd
debtor info.
Applicant 2 Info*
Company Name*
Contact Name,
Title*
Street Address*
City, State/Province,
Zip/Postal Code*
Country/Region
Phone*
x
Fax
E-Mail Address
Credit Amount
Requested*
Comments
Personal Guarantor?
YesNo
Last
Debtor ?
If this
is the last debtor, please scroll to the bottom of this
form to submit. Otherwise please continue with 3rd
debtor info.
Applicant 3 Info*
Company Name*
Contact Name,
Title*
Street Address*
City, State/Province,
Zip/Postal Code*
Country/Region
Phone*
x
Fax
E-Mail Address
Credit Amount
Requested*
Comments
Personal Guarantor?
YesNo
Last
Debtor ?
If this
is the last debtor, please scroll to the bottom of this
form to submit. Otherwise please continue with 4th
debtor info.
Applicant 4 Info*
Company Name*
Contact Name,
Title*
Street Address*
City, State/Province,
Zip/Postal Code*
Country/Region
Phone*
x
Fax
E-Mail Address
Credit Amount
Requested*
Comments
Personal Guarantor?
YesNo
Last
Debtor ?
If this
is the last debtor, please scroll to the bottom of this
form to submit. Otherwise please continue with 5th
debtor info.
Applicant 5 Info*
Company Name*
Contact Name,
Title*
Street Address*
City, State/Province,
Zip/Postal Code*
Country/Region
Phone*
x
Fax
E-Mail Address
Credit Amount
Requested*
Comments
Personal Guarantor?
YesNo
Please review your information
for accuracy, then click "Submit" below.
