Fill and Sign the Judgment Collection Form

Agreement and Assignment of Judgment for Collection to Collection AgencyAgreement made on the _____________ (date), between ________________________ (Name of Collection Agency), a corporation organized and existing under the laws of the state of _________________, with its principal office located at ______________________________ (street address, city, state, zip code) , referred to herein as Agency, and ____________________________ (Name of Client), a corporation organized and existing under the laws of the state of ______________________, with its principal office located at ___________________________________ (street address, city, state, zip code), referred to herein as Seller. For and in consideration of the mutual covenants contained in this Agreement, and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the parties agree as follows: 1. Services to be Performed To collect money Client is owed by ______________________ (Name of Debtor) pursuant to a Judgment rendered on ____________ (date) in the ______________________________ (Name of Court and Cause Number) for $_____________. 2. Best Efforts Agency will use his best efforts to collect the money due Client pursuant to said Judgment. 3. Agency’s Fee Agency’s Fee will be fifty percent (50%) of all sums collected. 4. Demand Letter Client agrees that Agency is authorized to initiate Collection by a demand letter. If payment is not made in full or substantially in full within ______ days of said Letter, Client hereby authorizes Agency to take such steps as he deems best to collect said Judgment including, but not limited to, writ of garnishment and judicial foreclosure. 5. Endorsement of Checks Client authorized Agency to endorse and negotiate and/or deposit checks collected on Client’s behalf into Agency’s account and withdraw Agency’s fees from said funds. 6. Authorization to Retain Legal Counsel Client authorizes Agency as Client’s agent to forward this matter to law firms and/or to associate legal counsel at no additional costs to client. 7. Forwarding and Deposit of Collected Funds Client agrees to forward to Agency all payments received directly from said Judgment Debtor for deposit into Agency’s account; in event same does not occur Client agree to pay Agency immediately the applicable collection fee on the said payment. The contingent rate is due to Agency if Client or any one designated by Client receive any funds or other consideration from any source by or on behalf of any person or entity against whom we are retained by you to pursue in this Collection matter. 8. Cessation of Collection Efforts Agency reserves the right to cease work on collection of this Judgment if Agency it to substantially “uncollectable" in his own discretion. This determination may include the decision that it is economically unfeasible for Agency to continue litigation or collection efforts because there are insufficient assets to justify collection. If in Agency’s opinion, the case involves an unsecured/ substantially uncollectible claim or bankruptcy, Agency reserves the right to withdraw representation. 9. Appointment of Agency as Attorney-in-Fact Client does hereby authorize Agency, as my agent, and Attorney-in-Fact, in my name, place, and stead, to receive, collect, and receipt for the amount due me on the Judgment and to satisfy the same on the Judgment Docket of the ______________________ (Name of Court) for the ______________________ (Name of County), ______________________ (Name of State), in my name, place, and stead, and to issue in my name, place, and stead any releases, acquittances, satisfactions, and the like, desired or requested by the Defendant in the above- stated matter. 10. Assignment of Judgment It is agreed that this instrument constitutes an assignment the Judgment and of all our rights and interest in any claim for the amount owed on the Judgment. You may initiate legal proceedings in your own name or take any other action deemed necessary by you for satisfaction of the claim. 11. Withdrawal of Agency If Agency withdraws or is discharged for any reason, Agency shall be entitled to receive from Client any and all monies due and owing to us on account of costs advanced. 12. Severability The invalidity of any portion of this Agreement will not and shall not be deemed to affect the validity of any other provision. If any provision of this Agreement is held to be invalid, the parties agree that the remaining provisions shall be deemed to be in full force and effect as if they had been executed by both parties subsequent to the expungement of the invalid provision. 13. No Waiver The failure of either party to this Agreement to insist upon the performance of any of the terms and conditions of this Agreement, or the waiver of any breach of any of the terms and conditions of this Agreement, shall not be construed as subsequently waiving any such terms and conditions, but the same shall continue and remain in full force and effect as if no such forbearance or waiver had occurred. 14. Governing Law This Agreement shall be governed by, construed, and enforced in accordance with the laws of the State of _____________. 15. Notices Unless provided herein to the contrary, any notice provided for or concerning this Agreement shall be in writing and shall be deemed sufficiently given when sent by certified or registered mail if sent to the respective address of each party as set forth at the beginning of this Agreement. 16. Mandatory Arbitration Any dispute under this Agreement shall be required to be resolved by binding arbitration of the parties hereto. If the parties cannot agree on an arbitrator, each party shall select one arbitrator and both arbitrators shall then select a third. The third arbitrator so selected shall arbitrate said dispute. The arbitration shall be governed by the rules of the American Arbitration Association then in force and effect. 17. Entire Agreement This Agreement shall constitute the entire Agreement between the parties and any prior understanding or representation of any kind preceding the date of this Agreement shall not be binding upon either party except to the extent incorporated in this Agreement. 18. Modification of Agreement Any modification of this Agreement or additional obligation assumed by either party in connection with this Agreement shall be binding only if placed in writing and signed by each party or an authorized representative of each party. 19. Assignment of Rights The rights of each party under this Agreement are personal to that party and may not be assigned or transferred to any other person, firm, corporation, or other entity without the prior, express, and written consent of the other party. 20. Counterparts This Agreement may be executed in any number of counterparts, each of which shall be deemed to be an original, but all of which together shall constitute but one and the same instrument. 21. Compliance with Laws In performing under this Agreement, all applicable governmental laws, regulations, orders, and other rules of duly-constituted authority will be followed and complied with in all respects by both parties. 22. In this Agreement, any reference to a party includes that party's heirs, executors, administrators, successors and assigns, singular includes plural and masculine includes feminine. Witness my signature as of the ______ day of _____________, 20______. ______________________ (Printed Name of Client) _______________________________ (Signature of Client) State of _____________ County of _____________ Personally appeared before me, the undersigned authority in and for the said County and State, on this _____________ (date), within my jurisdiction, the within-named ______________________ (Name of Client) , who acknowledged that he executed the above and foregoing instrument. ________________________________ NOTARY PUBLIC My Commission Expires: