TRS Recovery Services, Inc.
Consumer Collection Dispute Form
First Name
Middle Initial
Last Name
Street Address
Apartment #
Zip Code
Home Telephone No.
( )
Daytime Telephone No.
( )
Cell Phone No.
( )
Banking Information
Routing Number
Account Number
Routing Number
Account Number
Item in dispute and/or Reference Number (Provided at the top of the Notice)
Amount in Dispute
Reason for Dispute
Please write a detailed description of your dispute, including all check numbers, bank account numbers and dates involved.
Also, please attach to this form copies of additional documentation that will help support your dispute, such as payment
receipts, bank statements, etc. If you have a copy of a collection notice, you may also provide that document although you
are not required to do so.
Signature: Date :
TRS Recovery Services, Inc.
P.O. Box 674169
Marietta, GA 30006