Submit a Claim

Your Company information

Debtor information
Collection Efforts to Date

Agreement: Submission of this form constitutes an ongoing agreement with Creditor/Client that DRA will be paid 25% of any funds collected on this account and any other account submitted by Creditor/Client. If the submisson is a judgment DRA charges 33% of the amount collected. The contingent fee is not set by law but is negotiable between attorney and client. In the event the debtor returns merchandise to satisfy the debt Creditor/Client agrees to pay DRA 25% of the invoice value of said merchandise to DRA. If the Creditor/Client desires to pursue the debtor through litigation a separate Attorney/Client agreement will be required.