Delinquent Accounts

If you have received a call or letter from the Jordan Legal Group and would like to further discuss your account with us, please fill out and submit your information below so that a representative may contact you. If you believe any information is incorrect, we encourage you to Contact Us.

Please be reminded that this is an attempt to collect a debt by a debt collector and any information obtained will be used for that purpose.

JLG Account Number: *

Name: *

First

Last

Original Creditor: *

Phone: *

Fax:

Address: *

Address Line 1

City

State

Zip Code

Email: *

Confirm Email

Questions or Comments *

I hereby expressly consent to be contacted by The Jordan Legal Group or anyone calling on its behalf for any and all purposes, at any physical address, electronic address or telephone number I provide, including any wireless telephone number. I agree that The Jordan Legal Group or anyone calling on its behalf may contact me in any way, including but not limited to telephone calls and email messages delivered by manual means or by an automatic emailing system.

I hereby understand and agree that this is my consent and it cannot be revoked without the prior written agreement of The Jordan Legal Group.

I understand that in obtaining this consent, The Jordan Legal Group is acting in the capacity of a debt collector in an attempt to collect a debt and any information obtained will be used for that purpose.

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