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1. CreditMax will create a temporary password; and it will be emailed to you. Then you will have to change it when you login for the first time.
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About Buyer
*  Date:	1/27/2012
*  Salutation:	[select one] Mr. Mrs. Miss. Ms.
* First Name:
Middle Initial:
*  Last Name:
* Enterprise Name:
* Company Title:
* Company Name:
*  Company Type:	[select one] Collection Agency Debt Buyer Debt Buyer/Seller Debt Seller Issuer Law Firm Other
* Company Telephone:
Company Fax:
* Country:	Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory British Virgin Islands Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Croatia Cyprus Czech Republic Democratic Republic of Congo Denmark Disputed Territory Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Federated States of Micronesia Fiji Finland France French Guyana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard Island and Mcdonald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iraq Iraq-Saudi Arabia Neutral Zone Ireland Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Occupied Territories Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Saint Helena and Dependencies Saint Kitts and Nevis Saint Lucia Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia and Montenegro Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and South Sandwich Islands South Korea Spain Spratly Islands Sri Lanka Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks And Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United Nations Neutral Zone United States United States Minor Outlying Islands Uruguay US Virgin Islands Uzbekistan Vanuatu Vatican City Venezuela Vietnam Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe
* Address:
* City:
* State: ALABAMA ALASKA AMERICAN SAMOA ARIZONA ARKANSAS ARMED FORCES AFRICA ARMED FORCES AMERICAS ARMED FORCES PACIFIC CALIFORNIA COLORADO CONNECTICUT DELAWARE DISTRICT OF COLUMBIA FEDERATED STATES OF MICRONESIA FLORIDA GEORGIA GUAM HAWAII IDAHO ILLINOIS INDIANA IOWA KANSAS KENTUCKY LOUISIANA MAINE MARSHALL ISLANDS MARYLAND MASSACHUSETTS MICHIGAN MINNESOTA MISSISSIPPI MISSOURI MONTANA NA NEBRASKA NEVADA NEW HAMPSHIRE NEW JERSEY NEW MEXICO NEW YORK NORTH CAROLINA NORTH DAKOTA NORTHERN MARIANA ISLANDS OHIO OKLAHOMA OREGON PALAU PENNSYLVANIA PUERTO RICO RHODE ISLAND SOUTH CAROLINA SOUTH DAKOTA TENNESSEE TEXAS UTAH VERMONT VIRGIN ISLANDS VIRGINIA WASHINGTON WEST VIRGINIA WISCONSIN WYOMING
* Zip:
Purchaser Profile
* Professional   Membership(s):	ACA  DBA  NARCA  BAR None of the Above
Avg. Monthly Principal Balance Purchased:
Avg. Monthly Investment in Purchased Debt:
* No. attorneys in company:
* No. collectors in company :
* No. employees in company :
* No. locations in state:
Preferred Level of Debt Purchase:	Primary (0-6 months) Secondary (7-12 months) Tertiary (13-24 months) Quad+ (Over 25 months)
Preferred Type of Debt Purchase:	Credit Card Auto Deficiencies Judgments Consumer Loans Other (Please List):
* Preferred Location of Debt Purchase:	Northeast Region (CT, DE, MA, MD, ME, NH, NJ, PA, RI, VT) Southeast Region (AL, AR, FL, GA, KY, LA, MS, NC, SC, TN, VA, WV) Midwest Region (IA, IL, IN, KS, MI, MN, MO, ND, NE, OH, SD, WI) Southwest Region (TX, OK, NM, AZ) West (AK, CA, CO, HI, ID, MT, NV, OR, UT, WA, WY) Other Group of States: ALABAMA ALASKA AMERICAN SAMOA ARIZONA ARKANSAS ARMED FORCES AFRICA ARMED FORCES AMERICAS ARMED FORCES PACIFIC CALIFORNIA COLORADO CONNECTICUT DELAWARE DISTRICT OF COLUMBIA FEDERATED STATES OF MICRONESIA FLORIDA GEORGIA GUAM HAWAII IDAHO ILLINOIS INDIANA IOWA KANSAS KENTUCKY LOUISIANA MAINE MARSHALL ISLANDS MARYLAND MASSACHUSETTS MICHIGAN MINNESOTA MISSISSIPPI MISSOURI MONTANA NA NEBRASKA NEVADA NEW HAMPSHIRE NEW JERSEY NEW MEXICO NEW YORK NORTH CAROLINA NORTH DAKOTA NORTHERN MARIANA ISLANDS OHIO OKLAHOMA OREGON PALAU PENNSYLVANIA PUERTO RICO RHODE ISLAND SOUTH CAROLINA SOUTH DAKOTA TENNESSEE TEXAS UTAH VERMONT VIRGIN ISLANDS VIRGINIA WASHINGTON WEST VIRGINIA WISCONSIN WYOMING * You can select up to 5(five) states. ** To select multiple entries from state listbox, hold down the Control key on your keyboard as you click on the entry with your mouse.
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