Contact

P.O. Box 39695
Phoenix, AZ 85069

Toll Free: (888) 254-6967

Local: (602) 995-3494

Fax: (602) 995-9212

uscw@uscwest.com

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Request for Pre-Collect System


Your Information

 

Date:

   

Client Name:

   

Phone:

   

Fax:

   

Contact Name:

   

Email Address:

 

Debtor Information

   

First Name:

   

Last Name:

   

Address:

   

Address 2:

   

City:

   

State:

   

Zip Code:

   

Phone:

   

Fax:

   

Email Address:

   

Balance: