WCA CLAIM FORM
IMMEDIATE COLLECTION

IMMEDIATE COLLECTION I hereby authorize Wisconsin Credit Association to begin immediate collection on this case. TO EXPEDITITE COLLECTION, PLEASE SEND 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. You will receive a confirmation letter of receipt of this claim. Thank you for your confidence and for using WCA to collect your debt.
Voice ~ 262.827.2880
Fax ~ 262.827.2899

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Your Information (CREDITOR)
* Name:
* Company:
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* Fax Number: ( )
Street Address:
City:
State:
Zip Code:
* E-Mail Address:
Member Number: (Optional)

Subject Information (DEBTOR)

* Company:
* Street Address:
 
* City:
* State / Province:
* Country:
* Zip Code:
* Telephone Number: ( )
* Fax Number: ( )
Principal:

Amount of Claim $:

Comments / Special information including personal comments about this case that will be important in our collection efforts:

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