Professional Debt Collection by Attorney

Phone:	949-673-8674
Fax:	949-673-7762
E-mail:	cldonovan@earthlink.net

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Authorization Form

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Authorization Form

INSTRUCTIONS: Please fill out this form and return it either via fax or by mail. Once it is received, we will contact you, and collection efforts will begin immediately.

Your company name:
Contact person:
Street address:
City:
State:
Zip:
Telephone:
Facsimile:

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Debtor's company name:
Contact person:
Street address:
City:
State:
Zip:
Telephone:
Facsimile:
Amount of debt:
Date account opened:

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Collection efforts to date:

Special instructions:

E-mail address:

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***Preferred minimum of $2,000***
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By returning this form, you agree that The Donovan Group, Inc. shall be paid 25%, on a contingency basis, of any monies, returned goods or merchandise collected pre-litigation and 1/3 on all litigated matters. In the event litigation is necessary, a separate contract will be required.

Client

Date