Submit a Claim

Please answer these to the best of your ability. We can work together to fill in the gaps. Thank you for your submission! ~ Team CBC

Your Company
Name *
Phone *
Direct Contact
Business Phone
Business Phone
Address *
Authorization *
Do you authorize CannaBIZ Collects to act as your agent to collect this debt on your behalf?
Debtor's Info
Have you submitted this debt to another agency or attorney already? *
How old is this claim? *
Debtor History *
Please check all that Apply
Level of collection aggressiveness. We remain professional in every interaction but this guides us how to begin with each specific claim
Debtor's Name *
Debtor's Name
Debtor's Phone *
Debtor's Phone
Debtor's Address *
Debtor's Address
(if known)
Please take this opportunity to describe any special circumstances or conditions we should be made aware of before attempting to collect this debt.
Documentation Email to *
Before submitting this form please send an email to with all of the relavent documentation (i.e: agreements, contracts, purchase orders, invoices, text/email communication, etc.)