EFS Company

The following form is for your convenience. Creditor consents to EFS's use of any information provided by Creditor in pursuing collection of the account. Creditor represents and warrants to EFS the truth and accuracy of the information provided.

Debtor Information

Company Name :
Address:
City:
State:
Zip:
Amount Due:
Contact Name:
Phone:
Fax:
Email:
Acct #:
NSF Checks
Dispute Furnish Details
Remarks:
Client Information
Company:
Contact Person:
Email:
Address:
City:
State:
Zip:
Phone:
Fax:

To expedite collection - we may request copies of all available documents such as itemized statements - credit reports - purchase orders - signed applications - original NSF checks - personal or corporate guarantees and/or any pertinent correspondence substantiating this debt.

EFS, LLC
2210 Greene Way P.O. Box 20707 - Louisville, KY 40250-0707
Phone: (502) 495-0064 - FAX: (502) 495-1131
Toll Free: (800) 990-0378
Email: email@efscompany.com