Submit a Collection.

A copy of this submitted form will be sent to your email address...

Claim Details
Who Owes You Money - Debtor Company or Person's Name
Amount Owing
Enter without $ sign or commas. Example 5347.87
Your Customer Account # (if any)
Debtor Contact Details (Provide What You Can)
- Current Address
- Last Known Address
Address
Street Address City Province / State Postal Code / ZIP
Contact Name
Work Phone
Home Phone
Cell Phone
Email
Date of Birth of Individual Debtor (if known)
Debt Details
Last Invoice Date (When is this debt owing from)*
Last Payment Date (if any)
Known Assets
Property, vehicles, accounts receivable, employer, etc.
Type of Debt
NSF cheques, ignores all demands, broken promises, tell us what the debt is about.
CGI Credit Guard Inc. Client Details
You (Name of client of CGI Credit Guard)*
Your Address
Contact Person*
Your Email*
Your Phone*
Your Fax
Attachments
File
Attach documents such as a Statement, Invoices, NSF cheques, Credit Application, Contracts or anything else that would be useful. Accepted files: Word & Excel documents, JPG images, and PDF documents.
Drop files here or

Accepted file types: pdf, docx, doc, jpg, jpeg, xls, xlsx, Max. file size: 25 MB.
A copy of this submitted form will be sent to your email address.

By clicking on Submit, you agree to our terms and conditions. To view these terms and conditions, simply click HERE to view a PDF file that will open in a new window.
Email
This field is for validation purposes and should be left unchanged.

Claim Details