Online Dispute Application





Upload the documents that support your dispute, this upload is secure and confidential.

Downloadable Dispute Applications

Written Dispute Application

Download The Written Application
Completed Applications Can Be Faxed To:
1 877 640 5261

Fillable Dispute Application

Download The Fillable Application
Completed Applications Can Be Emailed To:
[email protected]

Payment Instructions

Payments can be Email Transferred to:
[email protected] 
Made online by clicking on the link below:
Make A Payment
Or made by Credit Card over the Phone by calling:
1 800 803 3216 Ext. 800
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Secure
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Safe
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Confidential