Debt Protest Form
Select your reason for protest
-- Select any option --
Wrong Person/Jr.Sr./Twins/Siblings/Divorced
Bankruptcy
Paid/Settled/Payment Plan/Dismissed
Improper Notice/Old Address/Never Received Notice
Did Not Possess or Own Property
Deceased
Business
Other
Select Did Not Possess or Own Property option if you were not in possession or did
not own the property at the time of the violation.
To help with the processing of your claim, you may submit a copy of your Driver's License, State ID
Card, Passport, or other picture identification with signature and date of birth, property deed, court
order or proof of sale, and anything else that supports your protest, up to a maximum of five documents.
Select Wrong Person or Jr./Sr. or Twins or Siblings or Divorced option if you are not
the correct person responsible for the debt.
To help with the processing of your claim, you may submit a copy of your Driver's License, State ID
Card, Passport, or other picture identification with signature and date of birth, divorce decree, and
anything else that supports your protest, up to a maximum of five documents.
Select Paid or Settled or Payment Plan or Dismissed option if you paid the debt in
full, settled the debt, entered into a payment plan, or the debt was dismissed.
To help with the processing of your claim, you may submit a copy of your Driver's License, State ID
Card, Passport, or other picture identification with signature and date of birth, receipt or proof of
payment, settlement agreement, payment plan, dismissal order or proof, and anything else that supports
your protest, up to a maximum of five documents.
Select Improper Notice or Old Address or Never Received Notice option if you did not
receive notification of the debt or the notification went to an old address.
To help with the processing of your claim, you may submit a copy of your Driver's License, State ID
Card, Passport, or other picture identification with signature and date of birth, two forms of proof of
old address (such as mortgage, lease, or utility bill), and anything else that supports your protest, up
to a maximum of five documents.
Select Deceased option if the person responsible for the debt is deceased.
To help with the processing of your claim, you may submit a copy of your Driver's license of Executor,
death certificate or obituary, and anything else that supports your protest, up to a maximum of five
documents.
Select Bankruptcy option if you are currently in bankruptcy, or if your previous
bankruptcy discharged the debt.
To help with the processing of your claim, you may submit a copy of your Driver's License, State ID
Card, Passport, or other picture identification with signature and date of birth, filing petition or
discharge order, and anything else that supports your protest, up to a maximum of five documents.
Select Other option if the other options do not adequately identify your protest
response. Please explain, in detail, your response in the space provided below.
To help with the processing of your claim, you may submit a copy of your Driver's License, State ID
Card, Passport, or other picture identification with signature and date of birth, and anything else that
supports your protest, up to a maximum of five documents.
Select Business option if you are not the correct Business responsible for the
debt.
To help with the processing of your claim, you may submit a copy of your Driver's License, State ID
Card, Passport, or other picture identification with signature and date of birth, and anything else that
supports your protest, up to a maximum of five documents.
Payment Date *
Former Address
State *
Select State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Executor *
Reason for Protest *
1000 Character(s) Remaining
You may add up to five documents to support your protest. Only pdf, jpg
or png file types are accepted. No Microsoft documents (word, excel, etc.) are allowed, but they may
be converted to pdf, scanned or photographed. Driver's license, State ID Card, Passport, or other
picture identification with signature and date of birth, property deed, court order, or proof of
sale, and any other documentation that supports your protest may be uploaded.