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Delinquent Account Collection History

Name: _________________________________________________________  Phone: _____________________________________________________

Address: ___________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________________

Contact: ________________________________________________________  Phone: _____________________________________________________

Date Account Opened:______________________________________________

Date Delinquent File Started:_________________________________________

Original Balance Due:______________________________________________


Date Amount Paid Balance Due History of Collection Efforts/Phone Calls/Letters
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       

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