Placement Form

Let’s Get Started

All of our fees are strictly contingent upon collection. Only fields with a * must be completed.

1Client Information

2Debtor Information

3Documents & Place Account

Your Company Name
Contact Full Name
Have you placed a claim with AFM in the past?
- Yes
- No
Address
Phone
Have you authorized AFM to report debtors to the Credit Bureaus?
- Yes
- No
City
Fax
Please download, fill out, and upload the Credit Bureau Authorization Form on Step 3
AFM Credit Bureau Authorization Form
State
Email (placement confirmation will be sent here)
Zip Code
AFM Sales Contact

Debtor Name
Phone
Balance Due
Address
Fax
Date of Oldest Open Invoice
MM slash DD slash YYYY
City
Owner/Officer/Contact Name
Date of Last Payment
MM slash DD slash YYYY
State
Job Title of Contact Listed
Do you have a signed Agreement that includes a provision for collection costs, attorney’s fees and/or court costs?
- Yes
- No
Zip Code
Mobile/Other Phone
Do you have a signed Agreement that includes a provision for finance fees/interest?
- Yes
- No
Your Account Number
Email
If you answered Yes to either of the two questions above, does the Balance written above include any accrued finance fees, collection costs or attorney’s fees?
- Yes
- No

Upload Backup Documentation
Documents Uploaded:
Drop files here or

Accepted file types: jpg, gif, png, pdf, doc, docx, mcw, wpd, wps, pages, xlsx, xlsm, xls, xlt, xml, txt, csv, Max. file size: 100 MB, Max. files: 8.
Additional Claim Information:
Confirmation
Please Process Claim For: Immediate Collection
*
*
- Immediate Collection
Would you like to place another claim after this submission?
- Yes
- No
American Financial Management's Terms and Conditions are acceptable*
*
- Agreed
Phone
This field is for validation purposes and should be left unchanged.

Information on Immediate Collection Processing

AFM’s Attorney Intervention Collection Program (aka: Immediate Collection) provides a stronger collection and adds enormous value to your collection efforts. On a contingency fee basis and from the very first day that we receive a new account for collection, an in-house AFM Attorney will directly work your file and contact the debtor to obtain immediate, voluntary payment. Our lawyers do not litigate. Rather, they solely focus on collection and account resolution by phone, email, facsimile and postal mail. AFM handles each assigned claim with professionalism, the utmost care and decisive action. We attempt to work each new file every single day for three straight days after we receive a new assignment to immediately, directly communicate with the debtor, incite urgency and collect the monies due as quick as possible. The immediate attorney involvement alone subconsciously creates a sense of urgency, so our immediate, persistent and respectful collection pursuits elicit a quicker response and payment. Further, the immediate attorney involvement provides a stronger likelihood to increase the quality of your claim (e.g. obtain a personal guaranty, promissory note, confession of judgment), while we collect the monies owed on your behalf. Also, if necessary, it sets the foundation for a comprehensive investigation to locate the obligor and learn the obligor’s payment capabilities, which will help you make an informed decision in responding to a settlement offer or if the debtor has not made payment within 60 – 90 days after you assign a file to our office and we provide you with the option to forward the claim to local counsel for possible legal action.

Information on Free Demand Processing

AFM offers a Free Demand Letter Series Program on commercial accounts that exceed $300.00. Specifically, AFM can send your delinquent customers finaldemand letters, covering a period of 10, 20, or 30-days, at absolutely no charge to you. AFM’s Free Demand program allows you to separate your customers that are truly customers from your past customers that are debtors and belong in collections. If you already know a past customer is a debtor, then AFM’s Attorney Intervention Collection Program (aka: Immediate Collection) will provide you with the most leverage and highest collection probability. From our experience, files involving a customer dispute, severe financial distress, or an opposing attorney are best served by immediate placement into AFM’s Immediate Collection program. After you choose a time frame, every 10 days, on AFM Letterhead, AFM will send a demand letter to your customer that directs all communications and payments to your office. The language within each demand letter becomes more stringent as the free demand period progresses. If payment is made to you during the free demand period and you notify us in writing of the payment received, then there is no charge whatsoever for the monies collected. It is absolutely free. However, if you do not receive payment in full during the Free Demand period, the account’s remaining balance automatically transfers into Immediate Collection.

Download a specific form below:

Placement Form – Free Demand Letter Series

Placement Form – Single Claim

Placement Form – Volume Claims

Submitting Backup Documentation

If backup documentation is not readily accessible, the maximum number of documents are already uploaded, or you prefer to submit backup documentation in a different manner, here are the various methods, and instructions, to submit the backup documentation to our office:

Email: Please email the documentation to placement@afm-usa.com and please reference the debtor name within the subject line of the email.

Fax: Please fax the documentation to 847-259-7014 and please describe the debtor name on the cover page of the fax.

Postal Mail: Please mail the documentation to American Financial Management, Inc., 5500 Pearl St, Suite 250, Rosemont, IL 60018.

American Financial Management, Inc. (“AFM”) Terms & Conditions

Confirmation Email and Additional Claim Submittal Instruction

Thank you for placing a claim with AFM.
Please check your email for confirmation that we received your claim.
Then, please review the information on step 1 and proceed to step 2 and step 3 to submit your next claim.

If you have any questions, please call or email our client services department at (847) 259-7000 x 115 or clientservices@afm-usa.com.