Free Debt Collection Evaluation Full Name (required) Email Address (required) Phone Number (required) Street Address City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareWashington DCFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennslyvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Name of debt collector/collection agency? What is the amount of debt? When was the last contact by either phone or letter? How are debt collectors contacting you? LetterHome PhoneWork PhoneCell PhoneOther If other, please explain: What type of debt are they trying to collect? Medical BillCredit Card BillUtility BillCar LoanOther If other, please explain: How many times have you been called? Has the collection agency or creditor commenced a legal action attempting to collect the debt? Choose OptionYesNo Please explain in detail how you feel that you have been treated unfairly: Comments? 12+48=?