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Case Evaluation Form

VERY IMPORTANT: Once you've completed this form and submitted it to us, you MUST also send us a copy of the original Judgment. You may send this to us via US mail, email, or fax:

Email: caseintake@JudgmentCollect.net

US Mail: P.O. Box 1234, Clawson, MI 48017

Fax: (888) 677-7413

All fields are required.

CREDITOR/PLAINTIFF INFORMATION:
Yes No
Yes No
- - (xxx-xxx-xxxx)
- - (xxx-xxx-xxxx)
INFORMATION ABOUT THE JUDGMENT:
Yes No
Yes No
Yes No
DEBTOR/DEFENDANT INFORMATION:

Who Was the Judgment Issued Against? Include All Defendants Whether Individuals or Businesses Entities: (See Caption on Judgment for all Defendant names)

If A Business:

- - (xxx-xxx-xxxx)
- - (xxx-xxx-xxxx)

If An Individual:

- - (xxx-xxx-xxxx)
- - (xxx-xxx-xxxx)
Yes No Not Sure
Yes No
W-2 Pay Stub Copy of SS Card
Yes No
I understand that my submitting this form in no way obligates JudgmentCollect.net to accept my case for collection.