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First Name *

Last Name *

Phone *

Email Address *

Skype / Telegram

Referred by

This is the business in which you have an agreement with the customer/account you are trying to collect from.

Business DBA *

Business Address *

Business City *

Business State *

Business Zip *

Business Country *

Business Phone *

This is to determine if you are a right fit for us to take you on as a client. Must have at least 100 accounts per month to place with us.

Unique Chargebacks Per Month

Unique Subscription Declines Per Month

Years in Business

Monthly Revenue Volume

Brief Business Description

We will attempt to recover the Principal balance plus fees you can pass on to the customer like the chargeback fee from your merchant processor plus an optional fee for collections services on these accounts. This will increase your overall collection amount, but must be disclosed in your terms and conditions.

Chargeback Fees *

Collection Fees *

Please provide ACH credit details so we can send you your monthly remittance. You will receive an ACH payment for previous month's collections activity around the first week of the next month.

Bank Name *

Routing *

DDA (Account Number) *

Partnering with Last Chance Recover has been a game changer. Their user-friendly portal and tailored strategies have consistently added over $20,000 in monthly profits that we would have otherwise missed. We highly recommend their services!