Assign Accounts for Immediate Collection!

Simply fill out the form below to assign your company's past-due B2B customer accounts, one at a time, for immediate collection. Or, to assign multiple B2B customers, please click here to use our template and simply enter "See Attached File" in the fields below. Then you can attach an entire folder to this form, including your completed template, all invoices and any other documents for each customer you're placing into collections.

You can also use your own spreadsheet, but please use our template to guide you on the fields of information we need. If you have any questions, please email collectnow@mrgpartners.com.

Client Information (Your Company's Information)Company NameContact First Name (Our contact for your company's assigned collection accounts)Contact Last NameHave you assigned collection accounts with MRG before?Your Email AddressYour Phone NumberYour Client # with MRG (if available, otherwise please disregard)Debtor Information (The Company That Owes You Money)
Debtor Business NameDebtor Contact Name and Title (if known)Debtor Phone #Debtor EmailDebtor Street Address

Suite, Building # Unit # as applicable

City

State

Zip Code

Debt InformationYour Company's Account/Reference # for this Debtor, if applicablePlease Enter the Date of the Most Recent InvoiceYour Preferred Collection Approach?$ Amount of Debt ObligationCurrencyThe following 2 boxes will ONLY be applicable if you have a Personal Guarantor that has agreed to be held personally liable.We have a signed Personal Guarantee in our contract, and/or a signed Promissory Note We also have the Guarantor's Social Security Number (Please check only if you have confirmed you have the SSN)Comments (Please provide any insights you feel should be considered during our collection efforts, including payment disputes, excuses etc.)

Upload File

Max file size 10MB. To attach multiple documents, simply attach an entire folder or zip file containing the invoices, credit app, contract etc.

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Disclaimer: By submitting this form you agree to the collection of your personal data pursuant to our privacy policy.

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