850 Carolier Lane • North Brunswick, NJ 08902
PHONE: 1 (732) 247-0300 • FAX 1 (732) 247-1395
TOLL FREE: 1 (800) 742-5278

“At Rickart Collection Systems we are dedicated to serving our clients and
providing exactly what they want – RESULTS!”

Retention of Agency: Client hereby retains Rickart Collection Systems, Inc. (RCS) to collect delinquent account(s) receivable of the Client which Client refers to RCS. The accounts referred by Client to RCS for collection shall be delinquent accounts assigned at the Client’s discretion. RCS may, at its discretion accept or reject the account for collection.

By completing and submitting this form, the Client agrees to employ RCS as its Agent to receive Client’s account information for debt owed to Client on assigned accounts. The creditor represents and warranties that he/she has provided all required Truth in Lending disclosures to each account holder and has obtained all necessary signatures so as to fully comply with the law.

The creditor further agrees to inform RCS upon its receipt of any information which would render the account information contained herein more complete, accurate, or obsolete, including but not limited to, notice of a consumer bankruptcy filing. Additionally, Client warrants that all accounts assigned to RCS for collection are valid obligations due and owing, legally enforceable debts.

EXISTING CLIENTS: PLEASE CONTACT OUR OFFICE FOR A REGULATION F COMPLIANCE ACCOUNT PLACEMENT INFORMATION REFERRAL SHEET.