Reporting Payments
To report a payment, please provide the information below:
Debtor's Last Name:
First Name:
Client's Name:
Your Account # :
Amount Paid :
Insurance Paid:
Write-Off:
Balance Owed:
Contact:
Comments:
Copyright 2005 California Accounts Service (619) 444-6116
PO Box 1622 El Cajon, CA 92022
