NACM Southwest

National Collection Service

A Division of the Dallas Association of Credit Management (NACM Southwest)
P.O. Box 167688
Irving, Texas 75016-7688
Phone: 972-518-0322
Fax: 972-580-9089

For further information and fee structure contact Delyn Simonis.

Account Placement

Please read our Terms and Conditions before completing the form.

Begin with the following service:

Immediate Personal Collection
Forward Now to Attorney
Send 10 Day Free Direct Demand Letter
Please Have Account Manager Phone Me

By submitting this form you agree to notify NACM Southwest promptly of any payments or response from debtor since commissions are based on the date NACM Southwest receives notification.

Debtor:				
Contact(s):			
Address:				
City:				
State:				
Zip Code:				
Phone Number:			
Debtor Fax Number:			
Email Address:			
Account Number:			
Amount Owing:

Please indicate below any information on the debtor that may be helpful since our chances of collection are enhanced when we have ALL the facts.

Additional Phone Numbers:		
Principals of Debtor:			
Debtor's Bank:			
Additional Information:

Please fax or mail any statements, credit reports, or details of disputes to NACM Southwest (972-580-9089)

Creditor:				
Address:				
City:				
State:				
Zip Code:				
Phone Number:			
Creditor Contact:			
Email Address:

Please complete the below form and NACM Southwest will add the info to the credit reporting database.

Year Opened:			
Last Sale Date:			
Payment Terms:			
High Credit:			
Account Balance:			
Actual Balance:	  		Current:  1 to 30:  31 to 60:  61+: 
Paying Record:			Discounts  Pays When Due  Days Slow

Comments:

Please submit all supporting documentation by fax (972-580-9089)

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