Appointment Of Collection Agent Template

Appointment of Collection Agent

Agent Name:

Seller Name:

Customer of Seller:

Customer Address:

Interview Date:

City:

State:

Zip:

Customer Phone No.

Email Address:

Account Receivable Balance: $

The Agent and Seller agree to the following conditions regarding the Customer account

receivable due:

The Agent is appointed, on behalf of the Seller, to collect the account receivable due by the

Customer.

The Agent shall receive

% of the amount collected. It shall be made payable

to the Agent once the Seller receives the payment.

The Seller will notify the Customer of the Agent’s collection efforts and appointments.

The Seller shall indemnify the Agent from any and all claims and conflicts that arise from the

account receivable and the Agent’s collection efforts.

The following qualifications shall also apply:

Agent Signature

Date Signed

Seller Signature

Date Signed

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Parent category: Business