[fusion_builder_container hundred_percent=”no” equal_height_columns=”no” menu_anchor=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=”” background_color=”” background_image=”” background_position=”center center” background_repeat=”no-repeat” fade=”no” background_parallax=”none” enable_mobile=”no” parallax_speed=”0.3″ video_mp4=”” video_webm=”” video_ogv=”” video_url=”” video_aspect_ratio=”16:9″ video_loop=”yes” video_mute=”yes” video_preview_image=”” border_size=”” border_color=”” border_style=”solid” margin_top=”” margin_bottom=”” padding_top=”” padding_right=”” padding_bottom=”” padding_left=””][fusion_builder_row][fusion_builder_column type=”1_1″ layout=”1_1″ spacing=”” center_content=”no” hover_type=”none” link=”” min_height=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=”” background_color=”” background_image=”” background_position=”left top” background_repeat=”no-repeat” border_size=”0″ border_color=”” border_style=”solid” border_position=”all” padding=”” dimension_margin=”” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=”” last=”no”][fusion_imageframe image_id=”179″ style_type=”none” stylecolor=”” hover_type=”none” bordersize=”” bordercolor=”” borderradius=”” align=”center” lightbox=”no” gallery_id=”” lightbox_image=”” alt=”” link=”” linktarget=”_self” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=”” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=””]http://37.60.231.87/~chris853/famspaymentonline/wp-content/uploads/2017/08/Bannerconfirm.jpg[/fusion_imageframe][/fusion_builder_column][fusion_builder_column type=”1_1″ layout=”1_1″ spacing=”” center_content=”no” hover_type=”none” link=”” min_height=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=”” background_color=”” background_image=”” background_position=”left top” background_repeat=”no-repeat” border_size=”0″ border_color=”” border_style=”solid” border_position=”all” padding=”” dimension_margin=”” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=”” last=”no”][fusion_text]Note: This form is not intended to notify FAMS that you are represented by an attorney. If you are represented by counsel, please complete and submit the Attorney Authorization Form. Thank you.

By submitting this Third-Party Consent Form to Financial Asset Management Systems, Inc. (FAMS), I hereby authorize FAMS to contact the third-party designated below regarding the referenced account. I acknowledge that any information sought or obtained from this person is an attempt to collect a debt and will be used for that purpose; and contact with the third-party will be made during the hours permitted by the Fair Debt Collection Practices Act (FDCPA), i.e., between 8 AM and 9 PM daily in the local area code for the third party’s telephone number indicated below:[/fusion_text][/fusion_builder_column][fusion_builder_column type=”1_1″ layout=”1_1″ spacing=”” center_content=”no” hover_type=”none” link=”” min_height=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=”” background_color=”” background_image=”” background_position=”left top” background_repeat=”no-repeat” border_size=”0″ border_color=”” border_style=”solid” border_position=”all” padding=”” dimension_margin=”” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=”” last=”no”][fusion_text]

We recognize that communications from consumers are time-critical. FAMS’ intention is to handle your notification promptly upon receipt. However, if we do not have sufficient information to locate and identify the correct account, we will not be able to act on your notification or inquiry. Please provide as much identifying information as possible by completing the fields below. We appreciate your cooperation.

    Name As It Is Listed On Account*

    First Name

    Last Name

    Middle Name/Initial

    Are You The Account Holder?*
    YesNo

    13 Digit FAMS ID Number

    Last 4 Digits of Account Holder SSN

    Find Your FAMS ID

    Name the entity to whom the debt is owed. (Not FAMS)

    Input the account number you have with the entity to whom the debt is owed. (Not FAMS)

    Address On Account

    City

    State

    ZIP code

    Phone Number As It Is Listed On Account

    Account Holder Email Address*

    Third-Party Name*

    First Name

    Last Name

    By providing your e-mail address and/or cell phone number to FAMS, you confirm your authorization for FAMS to communicate with you via e-mail and/or cell phone. If at any time you no longer wish to be contacted via email/cell phone, please notify FAMS immediately.

    Third-Party Email Address*

    Confirm Third-Party Email Address*

    Is This Your Email Address? *
    YesNo

    Third-Party Home Phone Number

    Third-Party Alternate Phone Number

    Third-Party Cellular Phone Number

    Best number at which to reach you?

    Account Type*

    Third-Party Address

    City

    State

    ZIP code

    [/fusion_text][fusion_text]Click here for additional state notifications.[/fusion_text][/fusion_builder_column][/fusion_builder_row][/fusion_builder_container]