Delinquent Account Collection History

This Delinquent Account Collection History is a form to track progress on delinquent

customer accounts and to record collection efforts. The form serves as a template for

the necessary information when a company is attempting to collect on delinquent

customer accounts. It contains the debtor's contact information, date account was

opened, original balance due, and any collection efforts taken by the company. It may

be customized to contain additional information to fit the specific needs of the user. This

form should be used by a company to keep track of its customers' delinquent accounts.

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DELINQUENT ACCOUNT COLLECTION HISTORY

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Debtor’s Name: Phone No.: g

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Address: t



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Contact: Phone:

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Date Account Opened:

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Date Delinquent File Started:

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Original Balance Due:

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Date Amount Balance Collection Efforts, Phone Calls, Letters,

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Paid Due and any other means o

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