WDX reserves all rights of admission into WDX.  Applicants are admitted or denied on the basis of industry experience, references and other factors.  To be considered for acceptance, please complete and submit this registration for eligibility to use the WDX Trading Software. 

YOU MUST PROVIDE THREE INDUSTRY REFERENCES WITH AT LEAST ONE OF THE REFERENCES BEING A COMPANY YOU HAVE PURCHASED DEBT PORTFOLIOS FROM IN THE PAST.  SUBMISSIONS WITHOUT THREE INDUSTRY REFERENCES WILL BE IMMEDIATELY DECLINED WITHOUT NOTICE.

Contact Information   * Required fields are marked in bold with an asterisk *Name    Title    *Organization         *STREET  ADDRESS  ONLY      *City    *State    - Select a State - International - N/A Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington D.C. West Virginia Wisconsin Wyoming *Zip    *Country    United States Afghanistan 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 Herzegowina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam 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 Cote D'Ivoire Croatia (Local Name: Hrvatska) Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France France, Metropolitan French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard And Mc Donald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran (Islamic Republic Of) Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea, Democratic People'S Republic Of Korea, Republic Of Kuwait Kyrgyzstan Lao People'S Democratic Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macau Macedonia, The Former Yugoslav Republic Of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States Of Moldova, Republic Of Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Kitts And Nevis Saint Lucia Saint Vincent And The Grenadines Samoa San Marino Sao Tome And Principe Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovakia (Slovak Republic) Slovenia Solomon Islands Somalia South Africa South Georgia And The South Sandwich Islands Spain Sri Lanka St. Helena St. Pierre And Miquelon Sudan Suriname Svalbard And Jan Mayen Islands Swaziland Sweden Switzerland Syrian Arab Republic Taiwan, Province Of China Tajikistan Tanzania, United Republic Of Thailand Togo Tokelau Tonga Trinidad And Tobago Tunisia Turkey Turkmenistan Turks And Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Vatican City State (Holy See) Venezuela Viet Nam Virgin Islands (British) Virgin Islands (U.S.) Wallis And Futuna Islands Western Sahara Yemen Yugoslavia Zaire Zambia Zimbabwe *Phone    - -  Ext.      *Fax    - -         *E-Mail

Which of the categories below best describes your professional involvement in the Consumer Credit Industry?    Creditor  Attorney  Information/Service Provider  Buyer  Broker  Collection Agency  Re-Trader  Other (please specify)

Are you interested in buying or selling . . .    Fresh Charge-Offs  Primary-Agency Recalls  Secondary-Agency Recalls  Tertiary-Agency Recalls  Post-Tertiary Agency Recalls

(optional) What is the total estimated face value of debt purchased or sold by your company to date?   $

What originations are you interested in . . .    Auto Deficiencies  Credit Cards    Commercial Loans  Consumer Loans  Installment Loans  Judgments  Medical  Private Label  Mortgages  Student Loans  Utility Chapter 13 BK  Checks      Out-of-Statute     In-Statute  Other        (Please Specify)

In what areas/states do you purchase or sell your paper?     Areas/States                  Are you interested in forward-flow opportunities?      Yes  No

How did you hear about us?     Select One Trade Show Trade Magazine Mailing Word of Mouth Referral Advertising Web Link Other

Any pending lawsuits against you or your company? Yes  No

If Yes, please explain:

Any outstanding judgments? Yes No If Yes, please explain: Any FDCPA/FCRA Violations? Yes No If Yes, please explain:     Any FDCPA/FCRA Training? Yes No         Please indicate if you are a member in an industry related organization    Debt Buyers' Association    American Collectors Association    Commercial Law League of America    National Association of Retail Collection Attorneys    American Bankers Association    Other

Notifications    Notify me by Email of portfolio listings.    Send product info to my Email address.

Please provide THREE industry references       Reference 1  Reference 2 Reference 3   *Name *Company *Phone Email (optional)         Comments

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