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 *
Direct Contact
Address *
Business Phone *
Business Phone
Debtor's Info
Have you submitted this debt to another agency or attorney already? *
How old is this claim? *
Debtor's Name *
Debtor's Name
Debtor's Phone *
Debtor's Phone
Debtor's Address *
Debtor's Address
Debtor History *
Please check all that Apply
Please include any other relevant information. Please email all accompanying documentation (ie contracts, purchase orders, invoices, etc) to your CBC rep.