Vascoe Valdes LLP - Collection Submission / Litigation Request

Your Name *
Your Phone Number *
Your Email Address *
Your Mailing Address *
If you are not owed the money personally; What is the name, address, and phone number of the party that is owed the money?
Why is money owed? (Description of goods/services/loans) *
Who owes the money? *
What is their address and phone number? *
Is there a contract or something in writing, showing the debt? *	Yes No
Who signed the contract?
Tell us about the contract or agreement
What was the total bill? *
Amount already paid? *
How much is owed? *
Can they afford to pay? *	Yes No
Have you asked for the money? *	Yes No
When did you last ask for the money? *
Who did you speak to last? *
What is their phone number? *
Tell us about the discussions and communications with them *
Do you have papers or documents that you would like to send to us? *	Yes No
Do you want us to represent you and collect this money? *	Yes No
This submission does NOT create an attorney-client relationship. Do you understand? *	Yes No
We do NOT represent you until we have signed our written Representation Agreement. Do you understand this? *	Yes No
Unless we already have a signed, and active, Representation Agreement; information submitted through this web site is NOT CONFIDENTIAL. Do you understand? *	Yes No

Vascoe Valdes LLP (281) 486-7700 --- We welcome your call.