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Debt Collection
Free Case Evaluation
Atlanta Lawyer Group
1401 Peachtree St., N.E. Suite 240
Atlanta, Georgia, 30309
Office:
404-607-7100
Fax:
404-607-7121
Personal Information
Your Name:*
Your Address:*
Email Address:*
Verify Email:*
Cell Phone:
Home Phone:
Office Phone:
Best Way to Contact You:
Debtor Information
Your Relationship to the Debtor:
Debtor’s Corporate and/or Individual Name:
Debtor’s Address:
Debtor’s Phone:
Date of Last Contact with Debtor:
/
/
Date of First Breach of Duty to Pay:
/
/
Additional Information
Describe the Situation:
Is there an Agreement to pay attorney fees if contract is breached?:
Describe collection efforts to date:
Describe any documents you have evidencing the debt:
Names of any Witnesses:
Are you looking for an hourly or contingency fee relationship?:
Has the debtor threatened bankruptcy or claimed bad cash flow?:
Final Information
I HAVE READ AND AGREE TO THE TERMS OF THE DISCLAIMER AND USE OF THIS EVALUATION FORM AS SET OUT
HERE
:
I AGREE
If you want to speak with someone in our office directly, please call 404-607-7100 (although filling out the form below would be very helpful to us).
All of your information will be kept strictly confidential.