Place Account For Collection

Eastern Credit Management Services accepts accounts by:

Telephone
Email (info@easterncms.com)
On-Line Placement
Fax or Mail (PDF: Account Placement Form)

Place Account for Collections

Please provide all the pertinent information you have at the time of placement including details of the account, support documentation, accurate balance including interest and/or service charges if applicable. If you receive payment after you have placed an account with Eastern Credit Management Services, please ensure that we are notified and contact us immediately!

Your Information
Your Company Name / Nom de votre enterprise
Your Address / Votre Adresse
Street AddressAddress Line 2CityProvincePostal Code
Email Address/ COURRIEL*
Debtor Information
Debtor Name / Nom de Debiteur
FirstLast
Debtor Spouse's Name/ CONJOINT(E)
FirstLast
Debtor Address / Adresse de debiteur
Street AddressAddress Line 2CityProvincePostal Code
Debtor Phone Number/ NUMBER DE TELEPHONE
Debtor Cell Phone Number/TELEPHONE CELLULAIRE
Debtor Work Phone/TELEPHONE AU TRAIVAIL
EMPLOYER / EMPLOYEUR
Debtor Email Address/ COURRIEL
Date of Last Payment / Date due dernier paiement
MM
DD
YYYY
Date of Last Charge or invoice / Date du dernier debit ou de la derniere facture
MM
DD
YYYY
Debtor Date of Birth/ DATE DE NAISSANCE
MM
DD
YYYY
Amount Due / Montant du
Account No. / No. due compte
SIN Number/ NAS
Pertinent Account Details / Details du compte
Captcha

Place Account For Collection

Place Account for Collections

Your Information

Debtor Information