Type of business:
Mail Order/Catalog     Internet     Manufacturer      Wholesale
Retail    Service Oriented     Professional     Legal
Medical     Entertainment     Non-Profit     Real Estate
Financial  Construction       Other

Number of employees:
1-5   5-10   10-25   25-50   50-100   100+

Billing: (check all that apply)
Invoice   Cash   Credit   
Monthly Statements   Accept checks by phone

Credit Cards Accepted: (check all that apply)
VISA  MC  AmEx  Discover

Is your company using a form of auto payments such as:
ACH/EFT     Auto-debit payments

Are your customer billing system/records computerized?
Yes   No

How do you bill?
By Invoice     Monthly Statements

How often do you bill?
Daily   Bi-Weekly   Monthly     Quarterly    Annually

Terms?
Immediate   Net 7   Net 30   Net 30-60+

Age of Receivables: Days Weeks Months

Would you like to reduce your collection time of your Receivables?
Yes     No

What is your company's biggest headache?


Which NSF check collection service do you currently use?
Telecheck(TM)   Check Right   Check Collect
DIRECT Collect   In-House   None
Other