This form must be submitted to us within 30 days of receiving your notice. The 30-day date can be found on your initial letter from us in the following paragraph:
Example: Unless you notify this office by phone or in writing by (30 days date) that you ......
If you notify us by the 30-day date, we must stop collection of the account until we provide you with the requested information below.
Section 1: Complete with all requested information. The Debtor & Account Number is located on the letter in the top right under your name and address.
Section 2: Choose one or both options. We will send you the requested information via mail.
This communication is from a debt collector and this is an attempt to collect a debt. Any information obtained will be used for that purpose.