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    Concerns About Turning Over Brothers/ Sisters for Collection?  
   
Receipt of Payment Notification Form
Use this form to report payments made direct to you
PROMPT REPORTING OF PAYMENTS DIRECT TO YOUR OFFICE IS VERY IMPORTANT SINCE WE ARE REQUIRED BY LAW TO MAINTAIN CORRECT, UP TO DATE INFORMATION IN OUR FILES.
If you choose to fax this form, CLICK HERE for the
PDF (requires Adobe Acrobat Reader)
Client (fraternity/sorority)
Client # (if known)
Date
Address
City    
State
Zip
Phone Number
The debtors(s) below has/have sent us payment direct to our office:
Debtor Name
Address
City
State
Zip
Date Payment Received
Amount Received $
Partial
Full
Remaining Balance $
P·B Client # (if available)
Person submitting this form
Greek Licensed Collection Services Serving Greek Organizations