Authorization to Send Collection Letter to Debtor - Pacific Rim Commercial Collections

Pacific Rim Commercial Collections

Authorization to Send Collection Letter to Debtor

Please fill out the following form and submit it to Pacific Rim Commercial Collections. The $30.00 fee can be paid by credit card by calling us at 818-991-5200.

Your Name: *

Day Phone: *

Name of Creditor (if different):

Date: *

Last Name *

Defendant #1

First Name:

Defendant #1

Middle Initial *

Defendant #1

Present Address: *

Defendant #1

Does Def. Own a Bus?:

Defendant #1

Name of Business *

Defendant #1

Type of Business: *

Defendant #1

Address of Business: *

Defendant #1

Business Phone: *

Employer Address: *

Defendant #1

Work Phone *

First Name: *

Defendant #2

Middle Initial: *

Defendant #2

Present Address: *

Defendant #2

Does Def. Own a Bus?:

Defendant #2

Name of Business: *

Defendant #2

Type of Business: *

Defendant #2

Address of Business: *

Defendant #2

Business Phone: *

Defendant #2

Contractor's License: *

Defendant #2

License No.: *

Defendant #2

Employer: *

Defendant #2

Employer Address: *

Defendant #2

Work Phone: *

Defendant #2

Home Phone: *

Defendant #2

Social Security No.: *

Defendant #2

Drivers License No.: *

Defendant #2

Date of Birth: *

Defendant #2

Bank Account #: *

Defendant #2

Branch: *

Defendant #2

Message