Please accept the captioned claim on our behalf and consider this our authorization for PCMA/Printing Industry Credit Bureau to proceed immediately with the collection process against the named 'debtor company'.

Upon acceptance of the captioned claim the following fees will apply: 20% contingency if collected by the agency, or 35% contingency should the assistance of an attorney be requested. We give PCMA/Printing Industries Credit Bureau authorization, as our agent, to accept payments, endorse checks, make notes, or accept other negotiable instruments in our name.

In the event legal action is recommended, we authorize PCMA/Printing Industries Credit Bureau to act as our agent in selecting an attorney and maintaining all contact. We agree that in the event a lawsuit is necessary we agree to pay all costs required to maintain the lawsuit filed on our behalf and understand that PCMA/Printing Industries Credit Bureau will obtain our authorization prior to any action being taken and before any costs are incurred.

Accounts withdrawn, paid, or settled by the creditor after the date of acknowledgment will incur a cancellation fee equal to the collection fee.

DEBTOR INFORMATION:

Please provide the following information, if available, to assist us in the collection process.