Call: 877-888-5657 Ext 102
Kevin@alazassoc.com
Free Rate Quote
The completion and submittion of the following form is not a placment of an account.  By submitting this completed form, you will receive a no cost, no obligation Free Rate Quote from our company.

     *Required Fields
1.  This is a request for a free rate quote to collect from a:


2.  Total amount outstanding;*








3.  Total number of accounts to collect form:*


4.  What is the average age ot the accounts:*



5.  How often do you use collection agencies?*




6.  Additional information regard the debt:









Contact Information:

*Your Name

*Company Name

City

*State

Zip

Country

*Telephone#

*Email Address


Your free rate quote request will be sent directly to us and you will be contacted in 24-48 hours by telephone or e-mail.
No Cost - No Obligation
Referred by
Business
Individual
Both
$0-999
$1000-4999
$5000-9,999
$10,000-14,999
$15,000-19,999
$20,000-29,999
$30,000-49,999
$50,000-74,999
$75,000-149,999
$150,000+
1
2-5
6-20
21-50
51+
1-30 days old
31-90 days old
91-180 days old
181-1 year
Over 1 year
Never
2-3 times per year
4-12 times per year
on an ongoing basis