| YOUR name and YOUR COMPANY'S NAME | |
| If you are not the original creditor,
please type the name of the ORIGINAL CREDITOR'S NAME (or company you are collecting for) | |
| Your toll free phone number and EXTENSION
if available, or your email address, or appropriate contact information for you | |
| IMPORTANT: Notification of bankruptcy
filings are mailed to your company from the U.S. Bankruptcy Court. Please give your MAILING ADDRESS where your company can
receive correspondence and receive all the information you need: | |
| My client's name(s): | |
| If you need a REFERENCE NUMBER to track
the client when I call you, you MUST give it, or any other information you will need, here: | |
| Account Number for the Debt: | |
| What is the amount of the debt? | |
| COMMENTS OR QUESTIONS: you may include
any comments, questions or additional information about this debt. | |
| Submission of this form is a good way to get information,
but like any email or electronic submission, is not 100% reliable. I try to return all inquiries from creditors, but am not
always able to do so due to the high number of requests. Repeated requests may not be answered. Incomplete requests (missing
information above) may not be answered. You may also fax requests to 704/377-0775 or call 704/37-0776 | |
| |
