Dispute Request Form Requestor's Name First Last Requestor's Email(Required) Dispute Type -Please select the box that the customer selected on the Reg F Form(Required) Reg F Form - This is not my debt Reg F Form- The amount is wrong Reg F Form - Other Regular Dispute - No Reg F form returned Request Type(Required) Verify debt/ bill is valid Verify amount due Death Certificate Divorce Decree Request report balance on the account Payment Research Bill of Sale Skip trace on out of state plates Request to remove collection fees Verify plate number/ Bad plate Other Please provide additional information for requestAccount, Statement or Plate Number(Required) Customer Name First Last Customer Email File Drop files here or Select files Accepted file types: jpg, pdf, png, xlsx, docx, Max. file size: 128 MB.
