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NorthWest Collectors
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Download Printable PDF Form Here

    ​PLACEMENT OF NEW BUSINESS - FOR CLIENTS ONLY
    TO BECOME A CLIENT CALL 406-541-3993 EXT 2

    Please read the following carefully and sign as indicated. Complete as much information as possible for each consumer. If there is anything unusual about the account, please let us know in the “Additional Information” section. For valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the undersigned does hereby sell, assign, transfer, and set over to Northwest Collectors the above listed debts, including, but not limited to, interest, service fees, damages, costs, or any other fees or amounts allowed by law or agreement with the debtor, authorizing and granting Northwest Collectors full right and power to collect, bring legal action, and discharge said indebtedness or claim in its own name and to do whatever it deems necessary to collect said amount. The undersigned covenants and represents that said amounts are justly due as of the received date and will provide verification upon request. Although payment may be received from the government, an insurance carrier, the debtor or any other source, this does not revoke or in any manner affect the assignment or Northwest Collectors’ right to the funds. 
    By giving your signature, you authorize Northwest Collectors to proceed with the collection on the debtor information provided on this form.
    ​Interest collected will be retained by Northwest Collectors to help defray the cost of collection. It is understood that Northwest Collectors has the authority to start suit on this account if necessary. Northwest Collectors advances the costs of any such action. Monies due you from collections made will be paid after deducting these costs. Northwest Collectors does not guarantee collection of any assigned account.
    PLEASE SEND A COPY OF THE ORIGINAL AGREEMENT SIGNED BY THE DEBTOR, SHOWING WHERE COLLECTION FEES AND/OR ATTORNEYS FEES CAN BE ADDED (IF ANY). Please send any additional supporting documents.
    Max file size: 20MB
    Max file size: 20MB

    Please fill out at least one of the the dates below before entering

Submit
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Phone: (406) 541-3993 
Toll Free: (844) 541-3993
Fax: (406) 578-3208
info@nwcollectors.com
1235 Kensington Ave
P.O. Box 2898
Missoula, MT 59801
​United States

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The Corporation holds membership in the
American Collectors Association and 
the Montana Collector's Association 
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