Agreement of Acceptance of Claim : Please fill out the following form. Please print your completed form if you would to have a copy for your records.




Date :


To :


Receipt is acknowledged of your claim against Mr. XXXXX for $ 9,000,000,000. Your claim is accepted for collection under the following terms and conditions.


Our experience or contacts with the debtor are shown by check marks preceding the appropriate statements.


1. Personal demand is being made upon the debtor. A further report will be made to you in 30 days.


2. The debtor is slow in payment, but we believe that we can collect your claim without suit.


3. The debtor must be sued. If you desire suit to be filed, please send duplicate invoices, statements of account, and the enclosed affidavit, properly executed, together with your check for $ 9,000,000,000 for advance court costs and suit fee. In the meantime, we shall try to effect an amicable settlement.


4. The debtor generally remits payment to the creditor immediately on our demand. Kindly advise us of direct remittances.


5. The debtor is in bankruptcy. Please execute the enclosed proof of claim and power of attorney and return them to us at once.


6. We have had ______ claims against the debtor and have collected on ______ of them.


7. We now have ______ claims against the debtor and are collecting them by______.


8. This debtor disputes the claim. Please furnish additional information concerning the claim and send us all original correspondence, together with any original orders, written acknowledgements, or promises to pay.


9. This debtor is out of business. The debtor has no property that can be levied on, and the debtor is not earning sufficient wages for garnishment. However, we believe the debtor will pay when possible. We will try to persuade the debtor to pay and shall keep you advised unless you advise us to return the claim to you.


Very truly yours,


_________________





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