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New Claim Placement Form

Having trouble with our online system or need assistance? Click here to get in touch.

Want to place multiple claims?

Click to fill out our multiple placement inquiry instead.

Client Address:

I provide Cosmopolitan Service Corporation authority to immediately proceed on our behalf to recover the following receivable. I accept the fee schedule pertinent to the terms and conditions.

Debtor Firm Address

Collection Type

Please provide us with any of the following documentation you may have available. You may also submit this documentation at a later time via email.

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Thank you for placing your claim with us. A representative will reach out shortly.

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