Client Debt Collection Abuse Intake Form |
Client Account Number : |
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Card Holder's Name : |
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State : |
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Contact Date : |
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Original Creditor : |
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Have you been sued by this Creditor? |
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Debt Collector : |
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Individual Calling : |
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Phone # of Caller : |
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Date of Abuse : |
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Number of times called : |
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Time : |
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Contacted Persons Name : |
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Contacted Persons Number : |
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May we contact them : |
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What happened? : |
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Contacted Persons Name : |
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Contacted Persons Number : |
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May we contact them : |
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What happened? : |
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Contacted Persons Name : |
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Contacted Persons Number : |
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May we contact them : |
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What happened? : |
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Contacted Persons Name : |
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Contacted Persons Number : |
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May we contact them : |
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What happened? : |
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Contacted Persons Name : |
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Contacted Persons Number : |
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May we contact them : |
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What happened? : |
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What happened? : |
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What happened? : |
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What happened? : |
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Please fill out information below if you know it, thank you. | |||||||||||
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