Collection Abuse Report Form

Do you have a case? If you believe you may have been victimized by debt collection abuse, discuss your case with one of our attorneys for free.

Please complete the brief form below and click "Submit".

Note: Any documentation that you have received (collection notices, threats of pending action, etc …) are helpful and can be faxed to: ATTN: Shannon Carter, (312) 372-1673. Please include a cover page with your fax that includes your name, phone number, and date of Collection Abuse Report Form submission.

About You
*Your Name
*Address
*City, *State, *zip  ,   
*Home Phone
Work Phone
Cell Phone
Fax
*E-mail


About the Event
Date of Event
Type of Event  Illegal charges
 Threatening or harassing creditor calls/letters
 Other (specify below)


What Happened?

Type directly into the text box or copy and paste from an existing word processing document. Must not exceed 400 words


How did you hear about us:

Google Ad
Web Search
Print Article/Editorial
Print Ad
Radio (including Online)
Radio Commercial
 Referral
Consumer Website Link
Current or Past Client
Labor Member/Representative
Labor Event/Meeting
Attorney Directory


Which of the following best categories your question or email?

Workers Comp
On-The-Job Injury
Auto Accident
Personal Injury
Injury / other
 Nursing Home
Abuse/Neglect
Consumer Debt Abuse
Defective Product
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Collection Abuse Reports may be considered a request for legal advice and/or request for a consultation with an attorney without charge or obligation. An attorney or his/her representative may be contacting you for more information, or to discuss your inquiry.

Your Privacy

Your privacy is important to us. Submitted information may be posted online for viewing by others without personal or identifying information .

Submission of this Collection Abuse Form does not constitute an attorney-client relationship. A free consultation and signed retainer agreement is required to establish such a relationship.

Read our full Privacy Policy.