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(State)
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
* Contact Name
Company
Address
City/State
* Phone
Alternate Phone
E-mail
(Type)
Commercial
Retail
Medical
Government
Checks
Other
(Amount)
Under $100
$100 - $500
$500 - $1,000
Over $1,000
(Amount)
Under $10,000
$10,000 - $25,000
$25,000 - $50,000
$50,000 - $100,000
$100,000 - $249,000
$250,000 - $500,000
$500,000 - $1 Million
Over $1 Million
(Amount)
Under 10
10 - 25
26 - 50
51 - 100
101 - 500
501 - 1,000
Over 1,000
(Amount)
Under $10,000
$10,000 - $25,000
$25,000 - $50,000
$50,000 - $100,000
$100,000 - $249,000
$250,000 - $500,000
$500,000 - $1 Million
Over $1 Million
Type of Accts.
Avg. acct Size
Total debt past due
No. of accts. past due
Est. written off last yr.
Comments
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