Online Intake Sheet Note: This sheet is to be filled out per claim. A Creditor (Client) can have multiple claims against their Debtor. To place multiple claims, please call 614-221-4129 and our office staff will assist you in this quick process. Existing ClientNew Client (see terms below) Schiff Debt Recovey Group Client Information SDRG Client Name* Existing Client ID Mailing Street Address* City* State* Zip* Suite Claim Submitted By* Contact Number* Email* Phone Number* Debtor Information Company Name* Mailing Street Address* City* State* Zip* Suite Physical Address* City* State* Zip* Suite Company Phone Number* Cell Phone Number Fax Number Date of last payment Balance of Claim* Date of Last Contact Attempt Result Where does the Debtor Bank Description of the Debt* Fed Tax ID/ Social Security Number Invoice Number/Account Number* Name of contact* Direct Number* History of Debtor Check all that apply* Debtor Has No MoneyDebtor Filed BankruptcyDebt is disputedDebtor has bounced previous checksBad Mailing AddressDebtor has been in debt with you beforeOther: Has Debtor Admitted or Accepted in Writing to Owing This Debt?* YesNo Are You Willing To Sue The Debtor* YesNo Proof of Claim (Supporting Documents)* Signed ContractPersonal GuarenteeCredit ApplicationStatement of AccountsInvoicesEmails/Texts/Letters stating agreementPromissory NotesCopy of ChecksOther Add your files here: * By selecting this box, you authorize our office to start collecting on this file, as well as agree to our terms and fee schedule.