Place An Account Online

Place An Account

Centralized Business Solutions Company is committed to providing you with a secure fast and efficient method of placing your delinquent accounts for collections. It is imperative that once a file is placed for collections all supporting documentation is either mailed or faxed to our office, no originals unless requested.

Cease all communication including collections activity with the debtor. Please enter all appropriate data in our placement form. Upon completion click the submit button. Our office will process your files immediately. In the event that you have multiple files that you want to submit online, you can email them in Excel or Word format to [email protected]

Client agrees to remit to Centralized Business Solutions Company all agency fees on monies which were paid directly from the debtor pursuant to the retention agreement. All monies are due within twenty days.

You can fax or mail all supporting documentation to:

Fax: 330-494-5944

Centralized Business Solutions Company
1225 N. Main St,
North Canton, OH 44720

Place An Account

Client Information

Fields with * need to be filled out.

*Company Name:

*Contact:

*Address:

*City:

*State:

*Zip:

*Telephone:

Fax:

*Email:

Consumer Placement

Debtor Information

*Type of Claim:

*Account Number:

*Name of Account:

*Responsible Party:

*Contact:

*Debtor Name:

Spouse's Name:

*Address:

*City:

*State:

*Zip:

*Debtor's Home Phone:

Debtor's Work Phone (preferred but not required):

*Basis of Claim:

*Original Amount Due:

*Current Amount Due:

Interest/fees Amount Due:

*Total Amount Due:

*Do you have a signed contract?

YesNo

*Debtor History:

*Service Date:

*Debtor's Birth Date: