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Prompt Payment Systems
Claim Placement Form

Complete the Form below and submit. Check the box to agree to the terms of the agreement before submitting.
You will receive immediate verification of your claim placement.

If you experience difficulty submitting the claim, contact Mary Mausbach mmausbach@andc.com or 800-456-5770.

* Required fields

Subject:

Creditor Name: *

Contact Name: *

Address: *

City, State, Zip: *

Country:

Phone: *

Fax:

E-Mail: *

Debtor Information-Claim 1

Debtor Contact Name: *

Debtor Address: *

City, State, Zip: *

Country:

Debtor Phone: *

Debtor Fax:

Debtor E-mail:

Debtor Cell Phone:

Debtor Social Security #:
(Consumer Claims only)

First Date of Delinquency:*
(00/00/0000)

Claim Amount: (USD) *

Comments/
Explanations:

Allied National, Inc.
Prompt Payment Systems
Terms and Conditions

STAGE I:

1. In the interest and spirit of maintaining the highest level of ethical and professional standards Allied National will perform all collection activities in accordance with the FDCPA, Fair Debt Collection Practices Act, and FCRA, Fair Credit Reporting Act. In addition, all collection activity will be conducted in compliance with the Code of Conduct of the ACA, American Collectors Association, as well as the standards set forth in the Operative Guidelines of the CLLA, Commercial Law League of America.

2. The Allied National Collection platform consists of a series of three demand letters that will be sent on behalf of Client/Creditor to selected debtors in intervals of 10 days. The debtor is directed to send all money to the client. Any recovery made within the first 60 days will not be subject to a contingency fee. Client receives and retains 100% of any recovery.

3. Each letter will include a demand for payment in full in addition to a notice and warning to each debtor that failure to pay the debt can result in the debt being reported to one, or all major credit bureaus: Experian, Trans Union, Equifax, Experian Business Credit and Dun & Bradstreet.

4. Courtesy Call/Final Warning: A follow up telephone call will be made to each debtor advising them that failure to pay within 21 days will result in the debt being reported to Credit Bureaus.

5. Reporting to Credit Bureaus: Allied National will report the delinquent status of each unpaid obligation to one or more of the major credit bureaus. To maintain compliance with the Fair Credit Reporting Act, we must show that we have made a demonstrable effort to allow the debtor to resolve the debt for a period of 60 days before reporting any claim to the credit bureaus. Furthermore, as a consequence of inadequate information not all debts will be reported to credit bureaus. Allied National does not guarantee or warrant that each and every debt will be reported to credit bureaus.

6. Nationwide Electronic Surveillance and Trigger Alerts: Allied National will list all skips and unpaid claims to an array of nationwide databases for the purpose of locating debtors for a period of up to 7 years. If and when a debtor's personal information has been changed or reported to Experian, Trans Union, Equifax, Microbuilt, CBC Innovis, Allied National will be alerted and the collection process will begin again.

7. Disputed or contested claims will be referred to the client for their respective reply and handling. Where it is determined that the debtor has a plausible and bona fide dispute all collection activity will be suspended and debt will not be reported to credit bureaus until such time that the dispute has been resolved and the debt remains unpaid.

8. Client/Creditor will inform Allied National immediately upon receipt of any payment. Upon notification Allied National will cease making any further demands for payment.

9. Client/Creditor will have 24X7 password protected access to the Allied National debt collection system on the website www.andc.com to place claims and view and monitor the status of all collection activity.

10. Each claim for Stage I will require an activation fee:

*  1 to 19 Activators: $40.00 per account

*  20 to 50 Activators: $18.00 per account

*  51 to 100 Activators: $15.00 per account

* 101 to 500 Activators: $12.00 per account

* 501 or more Activators: $10.00 per account

STAGE II:

Roll-Over Option to Case Management Services

At the conclusion of the three letter series the client has the option to roll-over any claim to the Allied National case management service level.  Vigorous and Aggressive debt collection efforts will continue and a contingency fee will apply on any funds collected or paid direct. 

Claims under $100 : 50%
Claims $101 to 200: $50 fixed fee
Claims $201 to $10,000: 25%
Claims $10,000 to $30,000: 20%
Claims $30,001 to $100.000: 15%
Claims over $100.000: fee negotiable

STAGE: III

Litigation Platform/Seeking the Assistance of the Courts

If we need to seek the assistance of the courts those fees and charges will be presented separately. No legal action will be taken without the written authorization of the client.

We have a nationwide network of attorneys the cover all 3,124 counties that make of the 50 States.

Litigation Fee Schedule:

Claims under $10.000.00  38% (Atty 25%, AN 13%) Plus court : estimated $500.00
Claims over $10,000.00 to $50,000.00 (Atty 25%, AN 10%) Plus court: estimated $500.00
Claims over $50,000.00 (Atty 20%, AN 10%) Plus court cost: estimated to $500.00

THANK YOU!
(Please check the box below.)
You must check the box to agree to the terms before submitting your claim.You must check the box to confirm the agreement to terms and conditions.
I agree to the terms and conditions found in the services agreement above. Bill me for the $40 activation fee.

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