Claim Evaluation Form

Please share some information about your company and your claim. I will normally respond within one business day. Please note the form itself does not create an attorney-client relationship, and we will need a signed fee agreement before proceeding with collections.

Tell Me About You

Company Name (include corp, LLC, etc.) (required)

First Name (required)

Last Name (required)

Position City (required) State (required) Phone Email (required) Nature of Your Business (goods sold, services provided, etc.) How You Found Me

Tell Me About Your Claim

Debtor Company's Name (include corp., LLC., etc.) (required) City (required) State (required) Amount of Claim (required) Age of Claim (required) Case Description (required) Supporting Documents Available (e.g., invoices, credit applications, emails, other records). (limit: 2mb)

Tell Me About You

Tell Me About Your Claim

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