Request Documentation

We understand additional documentation may be needed to resolve your account. Please provide the following:

Our File Number (If known)
Name on File*
Name on File
Address*
Street Address Address Line 2 City State ZIP Code
Home Phone
Work Phone
Cell Phone
Best Contact #*
Best Time To Call

: Hours

Minutes

AM/PM
Email Address*
Our Clients Name
Our Clients Name
Documentation Needed (check all that apply)
- Statement Only
- Itemized Statement
- Other
Other type of documentation
How can we help?
Email Communication*
- By checking this box – and – clicking submit, I give permission to Express Collections to e-mail information regarding my account(s). I may opt-out at any time.

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IMPORTANT NOTICE

If you have received a collection notice and are not sure what the bill is for or why the amount is due, you can request additional documentation from our office.

We will do our best to provide copies of contracts, service agreements, or invoices from the original creditor. Although this information may be readily available, some documentation may take up to 30 days to receive. Please provide us with a current address and contact information in case we need clarification on your request.